(AQW 2287/01)

The Minister of Health, Social Services and Public Safety (Ms de Brún): Responsibility for purchasing services rests with Health and Social Services Boards rather than the Trusts. All four Boards have purchased treatment for their residents outside the region over the last twelve months. Such cases may arise in the normal course of diagnosis and treatment protocols, where residents are referred for a specialist opinion or service not available locally, or where they have required emergency hospital admission when on a visit outside the region. In addition, patients may be referred to other centres as part of a waiting list initiative, to ensure that they are treated earlier than would otherwise be possible.

Based on past experience, approximately 1,300 patients would have been treated outside the region in the past year. Most of these would be subject to referral for specialist advice or emergency admission. As part of the special 2001-02 waiting list initiative, however, treatment was also arranged for 268 patients to undergo cardiac surgery.

Luíonn an fhreagracht do sheirbhísí ceannachta leis na Boird Sláinte agus Seirbhísí Sóisialta seachas leis na hIontaobhais. Tá cóireáil ceannaithe ag gach ceann de na ceithre Bhord do chónaithigh lasmuigh den réigiún thar na dá mhí déag seo caite. D’fhéadfadh cásanna den sórt sin tarlú i ngnáthchúrsa na fáthmheasa agus na bprótacal cóireála, áit a gcuirtear cónaithigh ar aghaidh do thuairim speisialtóra nó do sheirbhís nach mbíonn ar fáil go háitiúil, nó áit is gá iad a ligean isteach san ospidéal ar bhonn éigeandála agus iad ar cuairt lasmuigh den réigiún. Chomh maith leis sin, is féidir othair a chur ar aghaidh chuig lárionaid eile mar chuid de thionscnamh liosta feithimh, lena chinntiú go ndéantar cóireáil orthu níos túisce ná a d’fhéadfaí sin a dhéanamh seachas sin.

Bunaithe ar an taithí ón am a caitheadh, bheadh cóireáil déanta ar isteach agus amach le 1,300 othar lasmuigh den réigiún sa bhliain seo caite. Bheadh an chuid is mó de sin faoi réir chur ar aghaidh do chomhairle speisialtóra nó do ligean isteach in ospidéal ar bhonn éigeandála. Mar chuid de thionscnamh speisialta liosta feithimh 2001-02, áfach, socraíodh cóireáil freisin do 268 othar le dul faoi mháinliacht chairdiach.

(AQW 2574/01)

Ms de Brún: The information requested is not available.

Níl fáil ar an eolas a iarradh.

(AQW 2871/01)

Ms de Brún: Currently there are 680 (403.7 whole time equivalent) Treatment and Practice Room Nurses employed in Primary Care here. At December 2001 there were a total of 531 Health Visitors (447.61 whole time equivalent) and 342 District Nurses (318.37 whole time equivalent).

Tá 680 (403.7coibhéis lánaimseartha) Altra Seomra Cóireála agus Cleachtaidh fostaithe le haghaidh Príomchúraim anseo. Ag Mí na Nollag 2001 bhí 531 Cuairteoir Sláinte (447.61 coibhéis lánaimseartha) agus 342 Altra Dúiche (318.37 coibhéis lánaimseartha) in iomlán.

(AQW 3060/01)

Ms de Brún: As of 13 May 2002, a total of 53 couples had failed to qualify for sub-fertility treatment because they have children living with them.

Ó 13 Bealtaine 2002, theip ar 53 lánúin ina n-iarratas le cóireáil fhothorthúlachta a fháil mar go raibh páistí ina gcónaí leo.

(AQW 3065/01)

Ms de Brún: Over the six month period 1st October 2001 to 31st March 2002 the Fire Authority issued 17 Fire Certificates.

Thar an tréimhse sé mhí ó 1 Deireadh Fómhair go dtí 31 Márta 2002 d’eisigh an tÚdarás Dóiteáin 17 Teastas Dóiteáin.

(AQW 3232/01)

Ms de Brún: The list of medical conditions conferring exemption from prescription charges was introduced in 1968 after being agreed in discussion with the medical profession. These conditions are readily identifiable, permanent, life long conditions that require regular or extensive medication. The list has been reviewed on a number of occasions, most recently in 1998 by the Department of Health in England, but no clear-cut case for extending it has emerged.

I have no current plans to extend the list of medical conditions that confer exemption from prescription charges, to include any other medical condition. In 1968 only 42% of all prescription items were dispensed free of charge, whereas it is now some 90% here.

Tugadh liosta riochtaí míochaine isteach i 1968 a fuair díolúine ó mhuirir oidis i ndiaidh dóibh bheith comhaontaithe i bplé le gairm na míochaine. Is riochtaí inaimsithe go maith, buan, a mhaireann ar feadh an tsaoil iad a dteastaíonn leigheas rialta nó suntasach uathu. Athbhreithníodh an liosta ar roinnt ócáidí agus ba í an ócáid is déanaí in 1998 nuair a d’athbhreithnigh an Roinn Sláinte i Sasana é ach níor éirigh cás follasach as lena mhéadú.

Níl pleananna láithreacha agam an liosta riochtaí míochaine a mhéadú chun riocht eile míochaine a chur san áireamh a fhaigheann díolúine ó mhuirir oidis. Níor tugadh amach i 1968 ach 42% de gach mír oidis saor in aisce i gcomparáid le 90% éigin sa lá atá inniu ann anseo.

(AQW 3236/01)

Ms de Brún: Remicade has been made available here since November 1999, for a number of patients with this illness who have failed to respond to existing drug therapies.

The approach adopted here to the prescribing of these specialist drugs for the treatment of adults with severe rheumatoid arthritis and children with juvenile idiopathic arthritis, is broadly in line with the recent recommendations made by the National Institute of Clinical Excellence (NICE). While NICE endorsed the use of these drugs within clearly defined guidelines, it has identified the need for further assessment to determine their long-term clinical effectiveness.

A recent report by rheumatologists here has also concluded that while these drugs represent a major advancement in the treatment of this illness, it is essential that their use should continue to be strictly controlled and monitored, particularly in light of possible serious side effects. My Department is continuing to work with Boards and clinicians to promote a cautious approach to their introduction, within the resources available.

Cuireadh Remicade ar fáil ó Shamhain 1999 do roinnt othar a raibh an tinneas seo orthu nár éirigh leis na teiripithe drugaí dul i bhfeidhm orthu.

Cloíonn an cur chuige a tugadh isteach anseo maidir le tabhairt amach na saindrugaí seo ar mhaithe le cóir leighis a chur ar aosaigh a bhfuil géarairtríteas réamatóideach orthu agus páistí a bhfuil airtríteas ideapaiteach aosánach orthu a bheag nó a mhór le moltaí a rinne an Foras Náisiúnta d’Ardchaighdeán Feabhais Cliniciúil le gairid (FNAFC). Cé gur cheadaigh FNAFC úsáid na ndrugaí seo laistigh de threoirlínte soiléire, d’aimsigh sé an gá le haghaidh measúnaithe bhreise lena n-éifeacht fhadtéarmach chliniciúil a mheas.

Is é a toradh a bhí ar thuairisc le gairid a rinne réamaiteolaithe anseo ná cé gur dul chun cinn suntasach ar choireáil an tinnis seo na drugaí sin is éigeantach gur chóir go fóill a n-úsáid a shrianú agus a mhonatóireacht go righin, go háirithe agus an fhéidearthacht ann go mbeidh géar-sheachthorthaí ann. Tá an Roinn s’agam ag leanúint le hobair leis na Boird agus le cliniceoirí chun cur chuige faichilleach a chothú i dtaobh a dtabhairt isteach, ag obair laistigh de na hacmhainní ar fáil.

(AQW 3242/01)

Ms de Brún: Since its launch in September 2000, my Department has worked to establish appropriate implementation structures to ensure coherent and consistent delivery of the aims of the Strategy for Reducing Alcohol Related Harm.

In April 2001, a paper entitled ‘Model for the Joint Implementation of the Drug and Alcohol Strategies’ was presented to the then Ministerial Group on Drugs for consideration. The Ministerial Group approved the model, and on 17 May it received endorsement from the Executive. The structures include all key interests including local communities and allows for a concerted approach.

The joint implementation of both strategies is now underway and the new model includes the formation of six working groups to cover the following areas: Treatment, Education & Prevention, Communities, Information & Research, Social Legislation and Criminal Justice. The six Working Groups have developed Regional Action Plans based on the key output areas detailed in the Joint Implementation Model. These key outputs are based on the targets contained in the Drug and Alcohol Strategies. There are over 115 activities in the Regional Action Plans and all are time-bound. The Regional Action Plans have been finalised and Working Groups are due to meet in May to begin the task of taking the activities forward.

The four local Drug and Alcohol Coordination Teams have also developed Local Action Plans based on the Regional Activities. The Local Action Plans are presently being considered and will be finalised by the end of May.

All Action Plans will be published and available by early summer.

Óna lainseáil i Meán Fómhair 2000, d’oibrigh mo Roinn le struchtúir chuí fheidhmithe a chur i bhfeidhm a chinnteoidh go gcomhlíonfar aidhmeanna na Straitéise um Laghdú sa Dochar Bainteach le hAlcól go céillí agus go rialta.

In Aibreán 2001, cuireadh páipéar dar theideal ‘Creatlach le hAghaidh Chomhchur i bhFeidhm na Straitéisí Drugaí agus Alcóil’ faoi bhráid an iar-Ghrúpa Aireachta um Dhrugaí le haghaidh machnaimh. D’fhormheas an Grúpa Aireachta an chreatlach, agus ar 17 Bealtaine ghlac an Feidhmiúchán léi. Cuimsíonn na struchtúir na heochairpháirtithe leasmhara go léir chomh maith leis na pobail áitiúla agus cuireann siad cur chuige comhbheartaithe san áireamh.

Tá comhchur i bhfeidhm an dá straitéis faoi lánseol anois agus sa chreatlach tá bunú sé ghrúpa oibre le déileáil leis na réimsí seo a leanas: Cóireáil, Oideachas & Cosc, Pobail, Eolas & Taighde, Reachtaíocht Shóisialta agus Dlí Coiriúil. D’fhorbair na sé Ghrúpa Oibre Pleananna Réigiúnacha Gnímh bunaithe ar na réimsí príomhaschur léirithe go mion sa Chreatlach Chomhfheidhmithe. Tá na príomhaschuir seo bunaithe ar na spriocanna sna Straitéisí Drugaí agus Alcóil. Tá breis agus 115 gníomhaíocht sna Pleananna Réigiúnacha Gnímh agus tá teorainn ama orthu. Cuireadh an dlaoi mhullaigh ar na Pleananna Réigiúnacha Gnímh agus tá na Grúpaí Oibre le bualadh le chéile i mí na Bealtaine chun tús a chur le forbairt na ngníomhaíochtaí seo.

D’fhorbair na ceithre Fhoireann áitiúla Comhordaithe Drugaí agus Alcóil Pleananna Áitiúla Gnímh fosta bunaithe ar na Gníomhaíochtaí Réigiúnacha. Tá machnamh á dhéanamh ar na Pleananna Áitiúla Gnímh faoi láthair agus cuirfear an dlaoi mhullaigh orthu faoi dheireadh mhí na Bealtaine.

Foilseofar na Pleananna Gnímh go léir agus beidh siad ar fáil go luath sa samhradh.

(AQW 3243/01)

Ms de Brún: The Department of Health, Social Services and Public Safety does not hold any statistics on the causes of low birth weight.

Níl staitisticí ag an Roinn Sláinte, Seirbhísí Sóisialta agus Sábháilteachta Poiblí ar na cúiseanna atá le meáchan íseal breithe.

(AQW 3244/01)

Ms de Brún: All pregnant women receive advice from health care professionals, including, where appropriate, advice on the effects of smoking in pregnancy. In addition, all first time expectant mothers are given a copy of "The Pregnancy Book", which is produced in collaboration with the Health Promotion Agency and distributed by Health Boards. The Book contains a wealth of information about pregnancy, including advice on the benefits of giving up smoking.

I established an inter-sectoral Working Group on Tobacco in March last year to develop and oversee the implementation of a comprehensive Action Plan to tackle smoking. The Plan, which will identify pregnant women who smoke as a key target group, is being finalised and will be issued for consultation in the summer.

Tugann gairmithe cúraim shláinte comhairle do gach uile bean ag iompar clainne, agus más ceart í, comhairle ar sheachthorthaí chaitheamh tobac i rith iompar clainne fosta. Ina theannta sin, tugtar cóip den leabhar "The Pregnancy Book", curtha amach i gcomhar leis an Ghníomhaireacht um Chur Chun Cinn Sláinte agus scaipthe ag Boird Shláinte, do mhná atá ag dúil lena gcéad pháiste. Sa leabhar tá cuid mhór eolais ar thoircheas, agus tugann sé comhairle ar na tairbhí bainteach le héirí as tobac chomh maith.

Bhunaigh mé Grúpa idir-rannógach Oibre ar Thobac i Márta an bhliain seo a chuaigh thart le cur i bhfeidhm Plean Chuimsithigh Ghnímh le tabhairt faoi chaitheamh tobac a fhorbairt agus a stiúradh. Tá an dlaoi mhullaigh á cur ar an Phlean, a aithneoidh mná ag iompar clainne mar phríomhspriocdhream, agus cuirfear amach le haghaidh comhairlithe sa samhradh é.

(AQW 3246/01)

Ms de Brún: Foetal alcohol syndrome is a very serious disorder that can result in growth retardation, multiple physical abnormalities and severe learning disability. Research indicates that although maternal age and health as well as specific foetal susceptibility may contribute to the outcome for an infant whose mother drinks alcohol while pregnant, the potential harm to the foetus is much stronger with large amounts of maternal alcohol consumption than with smaller amounts. Pregnant women and those planning to become pregnant are advised to stop drinking or to limit alcohol consumption to one unit or two units of alcohol once or twice a week.

Is neamhord iontach tromchúiseach é siondróm alcól an fhéatais ar féidir le moilliú i bhfás, le hilmhínormáltachtaí fisiciúla agus le míchumas géar foghlama teacht as. Léiríonn taighde cé gur féidir le haois agus le sláinte na máthar chomh maith le claonadh ar leith chun galar an fhéatais bheith ina bhfachtóirí sa todhchaí maidir le saol an naíonáin a n-ólann a m(h)áthair alcól agus í ag iompar clainne, tá an dochar ionchasach don fhéatas níos láidire má ólann an mháthair méid mór alcóil ná méid beag. Moltar do mhná ag iompar clainne nó ag iarraidh le bheith ag iompar clainne gan a bheith ag ól alcóil, nó an méid alcóil a ólann siad a theorannú go haonad amháin nó go dhá aonad d’alcól uair amháin nó dhá uair sa tseachtain.

(AQW 3248/01)

Ms de Brún: My Department is currently funding 23 projects that are either health or community orientated. This includes a Needle and Syringe Exchange Scheme, which has the potential to bring drug users into contact with health professionals who are available to offer a range of advice as well as distributing clean materials. A 10-bed in-patient unit in Ballymena is also being funded and additional resources are being used to establish counselling services for young people in partnership with the Community Addiction Teams and specialist counselling agencies from the voluntary and community sector. Other projects funded aim to divert young people at risk of drug misuse into healthier pursuits and reintegrate recovering addicts into training and employment.

Cross-departmental and multi-sectoral working groups have recently developed a Regional Action Plan. The plan has a number of targets relating to treatment that will help to improve current services. Four local Action Plans, specific to Health Board areas have also been developed and will help to ensure that the targets contained in the Regional Action Plan are actioned locally.

Tá an Roinn s’agam faoi láthair ag maoiniú 23 tionscadal bunaithe ar an tsláinte nó ar an phobal. Tá Scéim Mhalartaithe Snathaide agus Steallaire, trínar féidir úsáideoirí drugaí a chur i dteagmháil le gairmithe sláinte atá ar fáil le réimse comhairle a thabhairt chomh maith le hábhair ghlana a scaipeadh. Tá aonad 10 leaba othar cónaitheach á mhaoiniú ar an Bhaile Meánach agus tá acmhainní breise á n-úsáid chun seirbhísí comhairliúcháin d’ógánaigh a bhunú i bpáirtíocht le Foirne Pobail Andúile agus sainghníomhaireachtaí comhairliúcháin ón earnáil dheonach agus pobail. Is é an aidhm atá leis na tionscadail eile ógánaigh i mbaol mí-úsáid drugaí a threorú i dtreo caitheamh aimsire níos sláintiúla agus andúiligh a bhfuil biseach orthu a mhealladh isteach sa traenáil agus san fhostaíocht arís.

D’fhorbair grúpaí oibre tras-roinne agus ilearnálacha Plean Gníomhaíochta Réigiúnach le gairid. Tá roinnt spriocanna ag an phlean a bhaineann le cóireáil a chuideodh le seirbhísí láithreacha a fheabhsú. Forbraíodh ceithre Phlean Gníomhaíochta áitiúla, a bhaineann le ceantair na mBord Sláinte áirithe agus a chuideodh le cinntiú go bhfuil na spriocanna sa Phlean Gníomhaíochta Réigiúnach curtha i ngníomh ar bhonn áitiúil.

(AQW 3253/01)

Ms de Brún: I refer the Member to my answer to AQW 3286/01.

Treoraím an Ball do mo fhreagra a thug mé ar AQW 3286/01.

(AQW 3258/01)

Ms de Brún: This information is detailed in the table below.

Tá an t-eolas seo mionléirithe sa tábla thíos.

(AQW 3286/01)

Ms de Brún: Scoliosis is a spinal deformity that may require very complex surgery undertaken by an expert in spinal surgery. The clinical condition of a number of children suffering from scoliosis was such that the opportunity for appropriate treatment was diminishing and the capacity to treat the number of children involved within a relatively short timescale was not available here.

While the unit in Scotland was able to provide facilities for scoliosis surgery, they were not able to provide the specialist surgical input. This necessitated the active participation of two local surgeons.

Is míchuma dromlaigh é Scolóis ina bhféadfadh go mbeadh ar shaineolaí tabhairt faoi mháinliacht chasta i máinliacht dromlaigh. Bhí an bhail chliniciúil a bhí ag dul do roinnt leanaí a raibh scolóis orthu sa chaoi is go raibh an deis a bhí ann cóireáil oiriúnach a fháil ag laghdú agus ní raibh sé ar ár gcumas anseo coireáil a thabhairt don líon leanaí a bhí i gceist laistigh den amscála a bhí réasúnta gearr.

Fad is a bhí an t-aonad in Albain ábalta saoráidí a sholáthar do mháinliacht scolóise ní raibh siad ábalta ionchur máinliachta speisialtóireachta a chur ar fáil. Dá bharr sin bhí sé riachtanach go mbeadh beirt mháinlia áitiúla páirteach go gníomhach ann.

(AQW 3309/01)

Ms de Brún: I refer the Member to my answer to AQW 3244/01.

Treoraím an Ball do mo fhreagra a thug mé ar AQW 3244/01.

(AQW 3310/01)

Ms de Brún: The Strategic Development Plan for the Ulster Hospital is in four Phases. Phase 1, addressing deficiencies in critical medical equipment was implemented in early 2001.

Phase 2, comprising nine projects addressing critical problems of capacity and continuity, started in mid-year 2001. Each of the projects will follow a different timescale and it is anticipated that all will be completed by September 2006.

Phases 3 and 4 will be kept under review in the light of the report of the Acute Hospitals Review Group and, following a period of public consultation, the Executive’s decisions on the long-term future of acute hospital services. The projected construction periods are three years for Phase 3 and four years for Phase 4.

Tá ceithre Chéim le Plean Forbartha Straitéiseach Otharlann Uladh. Céim 1, ag tabhairt faoi easnaimh géarthrealamh míochaine rud a cuireadh i bhfeidhm go luath i 2001.

Céim 2, ina raibh naoi dtionscadal ag tabhairt faoi ghéarfhadhbanna acmhainne agus leanúnachais, ar cuireadh tús leo i lár na bliana 2001. Beidh clár ama difriúil ag gach tionscadal agus táthar ag súil go mbeidh gach ní críochnaithe faoi Mheán Fómhair 2006.

Céimeanna 3 agus 4, beidh siad coinnithe faoi athbhreithniú mar gheall ar thuairisc an Ghrúpa Athbhreithnithe ar Ghéarotharlanna agus, i ndiaidh tréimhse comhairlithe phoiblí, ag brath ar chinní an Choiste Feidhmiúcháin ar thodhchaí fadtéarmach seirbhísí géarotharlann. Is é trí bliana an tréimhse tógála tuartha do Chéim 3 agus ceithre bliana do Chéim 4.

(AQW 3328/01)

(a) Information on waiting lists and waiting times is collected on the basis of time bands. It is not possible to derive an average from this information.

(b) In December 2001, there were 57,704 people waiting for inpatient admission to local hospitals, which equates to 3,398.8 per 100,000 of the population. At the same time, there were 131,166 people waiting for a first outpatient appointment at local hospitals, which equates to 7,725.8 per 100,000 of the population.

(a) Bailítear eolas ar liostaí feithimh agus ar amanna feithimh de réir bandaí ama. Ní féidir an meán a áireamh ón eolas seo.

(b) I Nollaig 2001, bhí 57,704 duine ag fanacht le dul isteach in otharlanna áitiúla mar othair chónaitheacha, is ionann sin agus 3,398.8 duine an 100,000 duine den daonra. Ag an am chéanna, bhí 131,166 duine ag fanacht ar a gcéad choinne éisothair in otharlanna áitiúla, is ionann sin agus 7,725.8 duine an 100,000 duine den daonra.

(AQW 3329/01)

Ms de Brún: The information is given in the table below:

² Qualified Nurses, midwives and health visitors.

Tugtar an t-eolas sa tábla thíos:

² Altraí, mná cabhrach agus cuairteoirí sláinte cáilithe.