Dec 16, 2014
Deputy John Deasy asked the Minister for Health the reason approval for the Fair Deal scheme is only provided from a current date, when many applicants are waiting 15 weeks for a decision, and have already taken up a nursing home bed; if his attention has been drawn to the difficulty that this poses financially, for elderly persons in need of this facility; and if he will make a statement on the matter.
REPLY (Minister of State Kathleen Lynch):
The HSE's National Guidelines for the Standardised Implementation of the Nursing Homes Support Scheme provide that State Support and Ancillary State Support should be paid from either the date that the release of funding is approved, or date of admission to the nursing home, whichever is the later. This is a necessary feature of the Scheme to enable the HSE to manage the budget for the Scheme.
The budget for the Nursing Homes Support Scheme in 2014 is €939m. At end of October 2014 (latest figures available) 21,926 people were supported by the Scheme. I am aware that waiting times on the Nursing Homes Support Scheme placement list have grown. This is not a satisfactory situation and I am trying to address it.
In addition to the budget for the Scheme, in July this year, the HSE allocated €5 million for an initiative to improve access to appropriate care for older people. To date, this has funded over 300 transitional care beds for patients in acute hospitals from the placement list for the Nursing Homes Support Scheme and over 200 home care packages to assist patients in the acute hospitals who require a home care package to be discharged.
The Government has provided additional funding of €25 million for 2015 to address delayed discharges, of which €10 million will be allocated to the Nursing Homes Support Scheme. In the longer term this issue requires an integrated response across primary, community, and residential services and my Department is working closely with the HSE to ensure that available resources are deployed in the most effective way possible.
Funding was released on 2nd December for just over 1,000 Nursing Home Support Scheme applicants, bringing the numbers on the placement list to 1,071 and reducing the waiting time for funding to 12 weeks.
April 9, 2014
Deputy John Deasy asked tthe Minister for Health the position regarding the proposed primary care centre for Dungarvan, County Waterford; if progress has been made in securing a PPP partner; and if he will make a statement on the matter.
Reply by Minister of State Alex White: Considerable progress has been made in developing the primary care centre PPP project. The HSE lodged the planning application for the Dungarvan primary care centre in November 2013 and has been advised that planning has been approved. Details are available on the local authority website.
The National Development Finance Agency (NDFA) published a Prior Indicative Notice (PIN) / Pre-Qualification Questionnaire in the OJEU on 19 December 2013. Four submissions were received by the closing date which was 10 March 2014.
Information can be located at the following web address: http://www.ndfa.ie/TenderCompetitions/PrimaryCareCentresPPPProgramme.htm
It is expected that 10-14 sites (indicative number 12 based on affordability) will be delivered as part of a single PPP contract with the remaining centres to be delivered by the HSE using other procurement means.
January 15, 2014
Deputy John Deasy asked the Minister for Health the steps being taken to ensure adequate service provision across Irish hospitals for Cystic Fibrosis patients, both children and adults, including specialist isolated treatment facilities, in view of the fact that Ireland has the highest CF rates in the world, with one in nineteen people here carrying the gene.
Reply from Minister James Reilly: Cystic Fibrosis is Ireland's most common life-threatening inherited disease. This Government is acutely aware of the challenges that people with cystic fibrosis and their families face in managing their condition and fully acknowledges the need for and supports the provision of dedicated accommodation in an environment which allows appropriate isolation for improved infection control. Given the need to avoid the exposure of CF patients to possible sources of infection, the aim is to minimise wherever possible the need to admit such patients to hospital and instead to provide treatment on an ambulatory daycare basis, as close as possible to home.
There has been significant investment in services for people with cystic fibrosis in the past few years including a new dedicated CF unit opened in 2012 at St Vincent's University Hospital, the National Adult Referral Centre; a new purpose-built dedicated Ambulatory Outpatient facility at Beaumont Hospital for patients with CF; a new outpatient facility at CUH which was completed with local philanthropic support from Build4Life as well as Exchequer funding. Other capital projects currently underway include a dedicated paediatric out-patient CF unit at Galway University Hospital which is expected to be completed during 2014; and the development of a CF unit in CUH, for which funding has been raised by Build4Life. As the Deputy will be aware, Build4Life has raised the issue of ringfencing of these beds for patients with CF. I understand that the HSE and Build4Life are now in a process which I hope will bring about a resolution shortly.
A further key initiative in recent years has been the introduction of newborn screening for cystic fibrosis in July 2011. This test is included as part of the National Newborn Bloodspot Screening Programme. Early identification and care will enhance the outcomes for children with CF. Last year, the new CF drug ivacaftor (Kalydeco) was made available and it is estimated that approximately 120 patients will be suitable for treatment with this new drug.
A Cystic Fibrosis Clinical Programme has now been established as one of the HSE's National Clinical Programmes. Its aim is to provide the framework to ensure that patients with CF receive optimal care to preserve/enhance their quality of life and improve health outcomes and wellbeing within the context of the three key objectives of all of the National Clinical Programmes - to improve the quality of care provided, to improve access to specialist services and to improve cost-effectiveness and efficiency.
January 15, 2014
Deputy John Deasy asked the Minister for Health if his attention has been drawn to the developing crisis regarding cystic fibrosis beds in Cork University Hospital; and the position regarding the supposed ringfencing of agreed beds for CF patients in the context of substantial fundraising by the Build4life voluntary charity.
Reply from Minister James Reilly: At the outset, I want to commend Build4Life on its achievement in raising €2.3m to fund this unit in Cork University Hospital. The situation that has now arisen in relation to this development is regrettable. I understand that the HSE and Build4Life are now in a process which I hope will bring about a resolution shortly.
I understand that the proposed Unit will have 20 beds, 10 of which will be designated for patients with CF, eight within the unit with two additional isolation beds provided in the Renal Unit. I have been assured that patients with CF will have priority access to these ten beds at all times. The ring fencing of beds for CF patients has been an issue in other hospitals around the country but has been resolved through written agreements and good operational procedures. I am confident that a similar agreement can be reached in this instance.
The key issue is that patients with CF are assured that sufficient beds will be available when they are needed, but at the same time, when beds are not needed for CF patients, they can be freed up for other very ill patients with respiratory and other conditions. I note that Cystic Fibrosis Ireland has expressed its confidence that, following discussions, an agreement can be drawn up that will allow building to commence.
January 15, 2014
Deputy John Deasy asked the Minister for Health the level of services that will be provided by the eye unit at Waterford Regional Hospital into the future in the context of the rearrangement of hospital services.
Reply from Minister James Reilly: Last May, I published the Government's plan to reorganise public hospitals into more efficient and accountable Hospital Groups which will harness the benefits of increased independence and greater control at local level. The establishment of acute hospitals into a small number of groups, each with its own governance and management, will, I believe, provide an optimum configuration for hospital services to deliver high-quality, safe patient care in a cost effective manner. The Deputy will be aware that the establishment of hospital groups was committed to in ‘Future Health: A Strategic Framework for Reform’ and is a key building block in delivering on the Programme for Government commitment to fundamentally reform our health service.
Hospital Groups will be required, within one year, to develop a strategic plan which will outline how they will provide more efficient and effective patient services; how they will reorganise these services to provide optimal care to the populations they serve; and how they will achieve maximum integration and synergy with other Groups and health services, particularly primary care and community based services. The role of individual hospitals within each group will be considered in detail in the context of this strategic plan.
Waterford Regional Hospital is part of the South/South West Group along with Cork University Hospital/CUMH; Mercy University Hospital; South Tipperary General Hospital; South Infirmary Victoria University Hospital; Kerry General Hospital, Bantry General Hospital; Mallow General Hospital, and Lourdes Orthopaedic Hospital, Kilcreene. It will therefore be a matter for the South/South West Group to determine where services, including ophthalmology, will be located within the Group, taking into account the health needs of the population as well as Government policy.
January 15, 2014
Deputy John Deasy asked the Minister for Health the position regarding the reported transfer of up to 1,200 cataract operations awaited by patients on the Waterford Regional Hospital list to private hospitals; the average cost to the Health Service Executive of outsourcing such surgery per patient; if there was any consultation with the salaried consultants at WRH who are both contracted and keen to carry out these procedures; and if he is concerned that this effectively represents a double payment by the State.
Reply from Minister James Reilly: In relation to the specific query raised by the Deputy, as this is a service matter it has been referred to the HSE for direct reply.