Written Answers Nos. 46-67
47. Deputy Gino Kenny asked the Minister for Health if he is aware that an organisation (details supplied) recently stated that the three main hospital waiting lists may increase by over 74,700 by the end of 2024 if current trends continue, an increase of 11% compared with the start of the year, and that the HSE’s 2024 waiting list targets are increasingly unlikely to be met; and if he will make a statement on the matter. [39361/24]
Amharc ar fhreagraIt is acknowledged that acute hospital waiting lists are too long, and that many patients are waiting an unacceptably long time for care.
As part of the multi-annual approach to reducing waiting lists, and just as importantly the length of time that patients are waiting, I published the 2024 Waiting List Action Plan on the 27th of March. Total funding of €360 million has been provided for the plan this year which sets out 19 Actions across three themes: Delivering Capacity, Reforming Scheduled Care and Enabling Scheduled Care Reform.
To date in 2024, additions to the waiting lists have been higher than projected. Whilst the volume target is proving a challenge driven by the rate of additions to the waiting lists, strong progress is being made in relation to the length of time patients are waiting for appointments for consultations and procedures.
There has been an 18% reduction in patients waiting over 12 months in the last year, building on the progress seen in 2022 and 2023, and the average waiting time for an OPD appointment has halved in the last 3 years.
The HSE has attributed the increases in waiting list additions to both demographic (for example: population growth, aging population) and non-demographic challenges (for example: increased awareness of services, new service developments, chronic disease and pent-up demand post COVID-19 pandemic). Increased pressure in Urgent and Emergency Care (UEC), can also impact on the availability of access to scheduled care. Both the HSE and the Department are monitoring these activity metrics and the associated targets from the 2024 WLAP.
Addressing waiting lists and times remains one of my top priorities, and we will continue to focus on this in 2025.
It is noted that the organisation referred to by the Deputy, indicates that their projections for waiting list volumes at the end of 2024 are based on an analysis of waiting list figures in the first seven months of the year. However, there are a number of factors which must also be factored into any projections of waiting list performance, including for example, seasonal trends in previous years.
48. Deputy Thomas Gould asked the Minister for Health for an update on the primary care centre for Blarney, Mayfield and Glanmire. [39378/24]
Amharc ar fhreagraAs the Health Service Executive (HSE) holds responsibility for the provision, along with the maintenance and operation of Primary Care Centres, I have asked the HSE to respond to the Deputy directly, as soon as possible.
49. Deputy Alan Farrell asked the Minister for Health for an update on progress to develop community healthcare options in Swords, County Dublin; and if he will make a statement on the matter. [39011/24]
Amharc ar fhreagraI have asked the HSE, as the agency with day-to-day responsibility for developing healthcare projects in Swords (including the Surgical Hub, Primary Health Care Centre, Elective Hospital and other related projects) to respond to you directly in relation to the matters raised.
50. Deputy Brendan Smith asked the Minister for Health if he will ensure that additional financial support is provided for healthcare services (details supplied); and if he will make a statement on the matter. [39420/24]
Amharc ar fhreagraThe National Cancer Strategy 2017-2026 recognises cancer support centres as a valuable resource, providing access to support to cancer patients and their families outside of the acute care setting. The HSE's National Cancer Control Programme (NCCP) works closely with a network of Community Cancer Support Centres, particularly in regard to the psycho-oncology model of care and the implementation of survivorship programmes for those living with and beyond cancer.
Community cancer support centres are voluntary and charity organisations delivering services directly to cancer patients and their families that emphasise the importance of quality of life during and after cancer treatment. These services can be availed of free of charge and in local communities. The NCCP Revised Best Practice Guidance for community cancer support centres was published in March 2022. The Alliance of Community Cancer Support Centres was also established in 2022. The Alliance is a HSE initiative which aims to develop a collaborative framework for community-based cancer support centres and services. This programme promotes participation in capacity-building activities and communication and networking forums aimed at ensuring that community-based cancer support services are integrated.
The NCCP operates an activity-based funding model for organisations who have joined the NCCP Alliance of Community Cancer Support Centres & Services.
In 2024, I allocated €3 million on a once-off basis to the Alliance of Community Cancer Support Centres. For 2025, I have secured a further €5.5 million for these centres, which will be allocated among community cancer support centres and services by the NCCP on a fair and transparent basis.
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.
51. Deputy Pádraig O'Sullivan asked the Minister for Health the number of children awaiting scoliosis surgery; the measures that have been taken to ensure timely treatment for these children; and if he will make a statement on the matter. [39279/24]
Amharc ar fhreagraI want to acknowledge that waiting lists for scoliosis and spina bifida services are unacceptably long. I am acutely conscious of the burden that this places on patients and their families.
I committed €19 million of current and capital funding to tackle these waiting lists by creating additional capacity. There was an increase in the number of spinal procedures carried out in 2022 and 2023, compared to 2019. The expected reduction in the waiting lists were offset by increases in demand and referrals compared to previous years. These services remain priority areas under the 2024 Waiting List Action Plan.
At the end of July 2024, there were 287 children on the inpatient waiting list for spinal procedures. This includes 44 who are on a suspended waiting list.
At my request, a dedicated Paediatric Spinal Surgery Management Unit was established earlier this year to focus on delivering improvements to the waiting lists. This Unit is working on improving capacity within CHI, expanding national outsourcing, and looking to maximise the international support.
A number of international outsourcing initiatives have been finalised. Children have been seen by clinicians from Morgan Stanley Children’s Hospital in New York, Great Ormond Street Hospital London and Portland Hospital in the UK.
I have also convened a dedicated stakeholder Paediatric Spinal Taskforce to collaboratively address concerns raised by families and advocacy groups.
I am chairing monthly meetings with the HSE and CHI to ensure that everything that can be done is being done.
52. Deputy David Cullinane asked the Minister for Health the composition of regional executive management teams; if this will include a chief health and social care professional; and if he will make a statement on the matter. [39369/24]
Amharc ar fhreagraHealth 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 has 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.
As you may be aware, the HSE CEO had made a decision based on the work conducted by a multidisciplinary group of HSE clinicians having taken feedback from REOs. It was agreed that for a three-year interim period there will be a Regional Clinical Director post and a Regional Executive Nurse Midwife post on the EMT with a view to moving to a single clinical lead post in three years’ time irrespective of profession. It was never the intention to exclude HSCPs from the process.
Notwithstanding this, concerns outlined to the HSE has required further reflection on the above. As part of the next stage of deliberation by REOs on the future state Integrated Service Delivery (ISD) arrangements, the HSE will give consideration to the HSCP leadership role in the context of regional EMTs. Further work will be required with the Chief Clinical Officer, REOs, DoH, HSCPs and staff representative bodies to consider any relevant structural adjustments at regional level to accommodate this. Any proposed executive function of such a role will need to be aligned to the Regional Clinical Director and Regional Executive Nurse Midwife roles respectively.
54. Deputy Paul Murphy asked the Minister for Health his views on the level of funding provided in budget 2025 for his Department; and if he will make a statement on the matter. [39380/24]
Amharc ar fhreagraI have secured a record level of €25.76 billion in funding for the Health Vote in Budget 2025. This includes the conversion of €0.93 billion of extra non-core funding of €1.03 billion given to health during Covid to permanent funding.
This means that 2025 sees an increase in permanent funding of €3.97 billion and an overall increase of €2.94 billion on 2024 levels, equivalent to a 12.9% increase.
This funding provides investment in new and better services, will ensure faster access to diagnosis and treatment, create more capacity and digitise the health service
56. Deputy Neasa Hourigan asked the Minister for Health when the Health Service Executive will issue its report on a ten-year plan for workforce planning; and if he will make a statement on the matter. [37293/24]
Amharc ar fhreagraThe Strategic Workforce Planning and Intelligence (SWP&I) Team in the HSE have engaged the Economic and Social Research Institute (ESRI) in a programme of research to develop a workforce projection model and undertake strategic workforce planning projections for a number of professions.
Workforce demand projections for acute hospital staff
In 2021, the Strategic Workforce Planning (SWP) team commenced working with the ESRI to extend the capability of the Hippocrates model to incorporate workforce projections. The project sought to analyse workforce demand across the public acute hospitals and undertake projections of demand for the following professions for the years from 2019 to 2035; Medical, Nursing and midwifery, Dietitians, Occupational therapists, Physiotherapists, Speech and language therapists, Social workers, Healthcare assistants and health and social care assistants.
The research report “Projections of workforce requirements for public acute hospitals in Ireland, 2019–2035:a regional analysis based on the Hippocrates model” was published in July 2022 and is available via www.esri.ie/system/files/publications/RS147.pdf
Workforce demand projections for Community staff
The HSE team are currently working with the ESRI to examine workforce requirements across care groups in the community. Undertaking this research is more complex as data is not readily available in the community on service users, such as age, sex, diagnosis, complexity of presentation nor can the workforce be easily aligned to community activity. Consequently, a bespoke research approach for each care group is being adopted.
The research is commencing with the following professions in Primary care: Physiotherapists, Occupational Therapists, Speech and Language Therapists, Psychologists and Dietitians, Audiologists, Podiatrists, Community nursing and Health and Social Care Assistants.
Relevant data has been provided to the ESRI by the HSE and the final component of workforce data validation and collection is nearing completion. It is anticipated that the workforce demand projections will be available by the end of quarter 4, 2024.
The team have also completed work with the ESRI to develop draft methodological approaches for adoption to undertake workforce demand projections for agreed professions who work in Mental health, Disability and Older persons services during which data requirements for these care groups has been identified. The extraction, collation and validation of relevant workforce data for mental health and older persons services has commenced to inform the detailed analysis to be undertaken by the ESRI.
It is anticipated that the workforce projections for the agreed professions across all care groups in the community will be concluded by the end of 2025.
57. Deputy Pauline Tully asked the Minister for Health the progress he has made, along with CORU, to streamline the timeframe to complete the recognition of qualifications and registration of those with non-Irish qualifications; and if he will make a statement on the matter. [39388/24]
Amharc ar fhreagraI can confirm that officials in my department are in regular contact with CORU where the matter of recognition and registration timelines have been discussed. CORU has made significant progress to reduce both recognition and registration timelines throughout 2024.
Regarding the recognition of non-Irish qualifications, recognition timelines from when a complete application has been received to a decision being made have significantly reduced since the start of 2024. Statistics provided by CORU show a decrease from an average of 88 days in January to 41 days in August, with some fluctuations month to month. This is despite the number of applications for recognition of non-Irish qualifications continuing to rise. A detailed breakdown by month and profession for 2024 is provided for information purposes and is being shared with the deputy.
There has also been significant improvement in average registration timelines generally, with an additional 3,000 applicants added to the register between March and August. Processing times have reduced over the same time period from 76 days in March to 45 days in August for all applicants. A detailed breakdown by month and profession from March to August 2024 is also provided for the deputy’s information.
These improvements are a result of several new initiatives and programmes of work to support changes being undertaken by CORU and include:
• The introduction of new pathways to recognition, in particular the Frequently Seen Qualifications programme which includes both programme alignment and standards alignment (currently in place for UK professional qualifications where standards align with those of Ireland). When good alignment of standards/qualifications can be confirmed, such applications do not require an individualised approach to recognition and can be ‘automatically’ recognised. The process currently applies to those presenting with UK qualifications only but CORU hope to expand the initiative to other countries going forward.
• Improvements resulting from the new integrated application/registrant system (currently in place for social care workers only but roll out for all professions expected by end-November).
• Delegation of low-risk decisions to the registrar which significantly reduces the timeline for recognition applications from a complete file being received to a final recognition decision.
• Improved engagement with stakeholders, including improved guidance material and simplification of document requirements.
• New training and procedures integration for assessors of applications, board members and the CORU recognition team.
59. Deputy Gino Kenny asked the Minister for Health if the clinical review of the medical cannabis access programme has been progressed; the current status of the programme; and when he plans to publish the findings. [39362/24]
Amharc ar fhreagraThe Department of Health is currently assembling the clinical review group. The clinical review group will examine the findings of the HRB's evidence synthesis publication to determine if there is sufficient evidence to expand the range of conditions covered by the MCAP. Recommendations will be made to me as Minister for Health as to whether sufficient evidence exists to include other conditions within the scope of the programme. It is anticipated that the clinical review will be completed early in the new year.
60. Deputy Pádraig O'Sullivan asked the Minister for Health the progress of an elective hospital at the St. Stephen’s site in Glanmire in County Cork; if a more indicative timeline for the project can be provided; and if he will make a statement on the matter. [39278/24]
Amharc ar fhreagraI have asked the HSE, as Sponsoring Agency with day-to-day responsibility for the development of the new elective hospital in Cork to respond to you directly in relation to the matters raised.
61. Deputy Richard Bruton asked the Minister for Health to outline his plans to develop the role pharmacists will play in the community; and if he will make a statement on the matter. [39406/24]
Amharc ar fhreagraI believe that pharmacists can do more for our health service. They can do more in our communities. Pharmacists are highly trusted, highly accessible and highly skilled. They’re in every town and village in Ireland. Pharmacists in the community already deliver many important services such as advice on prescription and non-prescription medicines, health interventions such as smoking cessation advice and healthy eating advice, and vaccinations.
In July 2023, I established the Expert Taskforce to Support the Expansion of the Role of Pharmacy. The remit of the Taskforce was to identify and support the delivery of specific objectives, which will serve to align services and practices that can be delivered by pharmacists, and pharmacies, with the needs of the health service and patients.
The Taskforce submitted their interim report to me in October of 2023. Extending the validity of prescriptions, and extension of prescriptions by pharmacists, was recommended by the Expert Taskforce. Officials in my Department, in collaboration with stakeholders, arranged for the implementation of this change, which began earlier this year.
The Taskforce continued to work together until July 2024. In August 2024, I accepted their recommendations and published their final report. The Taskforce recommended that pharmacists should be able to prescribe for a range of common conditions. They recommended an initial list of eight conditions which can be extended over time as the service evolves. The Taskforce also recommended the development, over the coming years, of more widespread models of pharmacist prescribing across the health service.
Enabling pharmacists to prescribe for common conditions (often called minor ailments) means pharmacists can provide advice and treat common conditions in the community. This will enable pharmacists to manage common conditions by offering advice, and, when appropriate, prescribing prescription-only medicines through established protocols.
I have established an Implementation Oversight Group which has representation from a number of organisations, including the Pharmaceutical Society of Ireland and the Irish Pharmacy Union.
The Implementation Oversight Group will be responsible for ensuring implementation of the common conditions service, development and delivery of training for pharmacists, optimising operational aspects of the service, overseeing the development of the necessary secondary legislation, and preparing and delivering communications to the public and other healthcare providers on these changes. I have asked that this service be put in place by early 2025.
The evolving healthcare landscape in Ireland necessitates innovative approaches to improve access to care. Pharmacist prescribing represents a significant opportunity to leverage pharmacists’ expertise, alleviate pressures on GPs, and provide timely care for common conditions. Expansion of the role of pharmacists in the community is an important step forward for our health service.
62. Deputy Catherine Connolly asked the Minister for Health further to Parliamentary Question No. 2022 of 23 July 2024, if the workforce plan has now been completed for a community nursing unit (details supplied); the number and grading of staffing required to safely increase the available beds to 38; when those 38 beds will be occupied; the number of people waiting to access a bed in this nursing unit and or to transfer from another nursing home or unit to this; and if he will make a statement on the matter. [38976/24]
Amharc ar fhreagraAs this is an operational matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
63. Deputy David Cullinane 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. [39370/24]
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.
64. Deputy Paul Donnelly asked the Minister for Health if funding can be allocated to a therapy service in Dublin to continue the essential work it does in the community in providing low-cost counselling (details supplied). [39172/24]
Amharc ar fhreagraAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
65. Deputy Cian O'Callaghan asked the Minister for Transport the recourse available to those injured by an e-bike, where the individual causing the injuries does not have the means for compensation or is unidentifiable; and if he will make a statement on the matter. [39491/24]
Amharc ar fhreagra66. Deputy Cian O'Callaghan asked the Minister for Transport for those injured by an e-bike, where the individual causing the injuries is without the means or unidentifiable, if the injured party can engage with PIAB or the MIBI; and if he will make a statement on the matter. [39492/24]
Amharc ar fhreagra67. Deputy Cian O'Callaghan asked the Minister for Transport if he will investigate an incident (details supplied) where an individual was injured by an e-bike; the role of the newly implemented Road Traffic and Roads Act 2023 for injured parties; and if he will make a statement on the matter. [39493/24]
Amharc ar fhreagraI propose to take Questions Nos. 65 to 67, inclusive, together.
The Deputy will appreciate that I cannot comment on specific incidents, cases being investigated by An Garda Síochána or individual insurance or compensation claims.
The Road Traffic and Roads Act 2023 makes a clear regulatory distinction between low-powered, pedal-assisted electric bikes, which are treated in the same way as pedal cycles, and more powerful, throttle-assisted bikes, many of which (with the exception of the lighter L1e-A category) are now classed as e-mopeds (L1e-B) and therefore are mechanically-propelled vehicles (MPVs). A detailed category-by-category description of the distinction between e-bikes and e-mopeds is available at: www.gov.ie/en/publication/3be70-find-your-category/
Only L1e-B e-mopeds, and not low-powered electric bikes, are required to be insured under the Road Traffic Acts and only this category falls under the remit of the Motor Insurers’ Bureau of Ireland (MIBI), which compensates victims of road traffic accidents caused by uninsured and unidentified vehicles.
An individual who has been injured in a collision with a low-powered e-bike or a pedal cycle has the option of making a claim to the Personal Injuries Resolution Board (formerly the Personal Injuries Assessment Board), which is the independent State body responsible for resolving personal injury claims.
