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Thursday, 20 Oct 2022

Written Answers Nos. 101-120

Mental Health Services

Questions (101)

David Cullinane

Question:

101. Deputy David Cullinane asked the Minister for Health his plans for the full roll-out of early intervention in psychosis services; and if he will make a statement on the matter. [52302/22]

View answer

Written answers

The Model of Care for the National Clinical Programme in Early Intervention in Psychosis (EIP) is a joint initiative between the HSE and the College of Psychiatrists of Ireland, and was launched in June 2019. The implementation of the EIP Model of Care is in line with Sharing the Vision. The EIP programme will ensure that people presenting with psychosis get rapid access to expert assessment and evidence based intervention including psychological interventions, family interventions, employment support, physical health support and medication.

Early Intervention in Psychosis is an evidence-based approach that can transform the experiences and outcomes of people facing psychosis. Investment in this vital clinical programme can help reduce admissions to hospital, reduce relapses, prevent long-term disability and support people to stay in education and/or employment.

Each year in Ireland an estimated 1,500 people develop psychotic disorder for the first time. Approximately 25 EIP services must be developed in Ireland to facilitate national implementation of this clinical programme, in line with Recommendation 52 of Sharing the Vision.

There are currently 5 EIP services in place across CHOs 1, 4, 6, and 8. All are at various stages of development and resourcing in terms of progressing the Model of Care. Three of these EIP services formed part of an external evaluation, the report of which was launched on 22 September 2022.

There is strong interest from clinicians to work on EIP teams and posts funded in 2022 are being progressed by each CHO. In some cases, backfilling of posts can take some time, resulting in gaps in teams. However, we continue to make positive progress in relation to recruitment for this important programme.

Primary Care Services

Questions (102)

Seán Canney

Question:

102. Deputy Seán Canney asked the Minister for Health when he expects the long-delayed x-ray facilities to be up and running in Tuam primary care centre; and if he will make a statement on the matter. [51143/22]

View answer

Awaiting reply from the Department.

Mental Health Services

Questions (103)

Christopher O'Sullivan

Question:

103. Deputy Christopher O'Sullivan asked the Minister for Health if he will re-evaluate the eligibility criteria currently being used by the HSE mental health services for counsellor / therapist positions which seem to be restrictive (details supplied); if the same criteria are to be used for counsellor / therapist positions in schools; and if he will make a statement on the matter. [52409/22]

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Written answers

Counsellors and psychotherapists are among a list of professions that CORU’s website confirms are soon to be regulated. The link below confirms this.

coru.ie/about-us/what-is-coru/

In February 2019 the then Minister for Health, Simon Harris TD, confirmed the establishment of, and appointment of members to, the Counsellors and Psychotherapists Registration Board, under the Health and Social Care Professionals Act 2005 (amended) to regulate the professions of Counsellors and Psychotherapists.  The Counsellors and Psychotherapists Registration Board at CORU has statutory responsibility for:

- Establishing and maintaining a Register of members of the profession

- Assessing, approving and monitoring training courses for the health and social care professions under the Act

- Establishing the Code of Professional Conduct and Ethics and standards of performance to which counsellors and psychotherapists must adhere.

https://coru.ie/about-us/registration-boards/counsellors-and-psychotherapists-registration-board/about-the-counsellors-and-psychotherapists-registration-board/

HSE eligibility criteria are approved by the National Director of HR under powers conferred on her by s.22 of the Health Act 2004. Currently, eligibility criteria for certain grades of counsellor/therapist within the National Counselling Service and the Employee Assistance Programme have had their eligibility criteria so determined. But there are other grades of counsellor, therapist, and psychotherapist that have not had their eligibility criteria formally approved. Whether or not eligibility criteria have been formally approved, the first criterion will invariably specify an academic qualification, usually couched as one of a number of alternative courses. However, once CORU registration is required, the first criterion in any set of eligibility criteria for posts in this sphere will be that

“…candidates must be registered or eligible to be registered in the appropriate division of the Counsellors and Psychotherapists Registration Board maintained by CORU”

The precise wording will be agreed when the CORU register closes.

When the register closes, all counsellors and psychotherapists will require to be registered with CORU. It will then be for CORU to determine which qualifications within and outwith the State will entitle applicants to be registered. HSE eligibility criteria will no longer have to specify which academic qualifications make an applicant eligible for CORU registration.

Covid-19 Pandemic

Questions (104)

Gino Kenny

Question:

104. Deputy Gino Kenny asked the Minister for Health if his attention has been drawn to a call by an organisation (details supplied) for ventilation in hospitals to be examined, to ensure the safety of nurses and midwives in their workplaces; and if he will make a statement on the matter. [52403/22]

View answer

Written answers

Thank you, Deputy.

Building ventilation has remained an important component of our broader infection prevention and control response over the course of the COVID-19 pandemic, both at population and sectoral levels. It should also be noted that the most effective way to reduce the impact of this disease is for those who are experiencing symptoms of COVID-19 to self-isolate until 48 hours after symptoms have substantially or fully resolved, and for those who are eligible to receive their primary and booster doses.

With regard to ventilation in the healthcare sector, it is one aspect of a suite of measures that are used in hospitals and other healthcare settings to mitigate the spread of respiratory infection, including COVID-19. It is important to remember that other preventative measures are still advised in healthcare settings, including respiratory hygiene and cough etiquette and appropriate use of PPE, including face masks.

The HSE’s Antimicrobial Resistance and Infection Control Division (AMRIC), publishes infection prevention and control guidance for healthcare settings.

On 22nd September last, the AMRIC published the latest iteration of its Acute Hospital Infection Prevention and Control Precautions for possible or confirmed COVID-19 cases, which provides specific guidance with respect to ventilation in hospital settings. The guidance is published on the Health Protection and Surveillance Centre’s website and will continue to be regularly updated. The HSE implemented the guidance on 3rd October.

Additionally, on 12th October, I published my Department’s Strategic Approach to the Management of COVID-19 for Winter 2022/23. The Department’s strategic objectives are presented thematically in the report. This report was informed by the work of the COVID-19 Advisory Group, whose multidisciplinary membership includes an expert on ventilation. Information is provided on ventilation under the heading of non-pharmaceutical interventions.

The importance of ventilation as one measure within our overall layered response to mitigate the spread of COVID-19 is also embedded in Government communications on the pandemic. This will continue to be the case in upcoming campaigns.

Disability Services

Questions (105)

Richard Boyd Barrett

Question:

105. Deputy Richard Boyd Barrett asked the Minister for Health the action that he intends to take concerning the ongoing inability to staff the disability network teams; the impact that is having on early intervention for children with developmental delays; and if he will make a statement on the matter. [50101/22]

View answer

Written answers

Since 2019, more than 475 new posts have been funded to Children’s Disability Network Teams (CDNTs) across the country. In addition, further to recent discussions with An Taoiseach and relevant Government Ministers, the HSE and its CDNT Lead Agencies will receive funding for an additional 136.3 WTEs to provide services in 104 special schools. 

However, the health and social care sector is experiencing ongoing challenges in both recruiting and retaining staff. With regard to CDNTs, this has impacted on the ability of the HSE to recruit to these areas. 

The HSE continues to explore a range of options to enhance the recruitment and retention of essential staff across all aspects of the health services, including for CDNTs. In addition, the HSE Community Operations Disability Services is working collaboratively with the CDNT lead agencies at CHO level to promote CDNTs as a workplace of choice in a competitive employment market.

National Children's Hospital

Questions (106)

David Cullinane

Question:

106. Deputy David Cullinane asked the Minister for Health his plans for electronic health records; and if he will make a statement on the matter. [52303/22]

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Written answers

I thank the Deputy for his question. Considerable progress has been made on Electronic Health Records (EHR) systems for the New Children’s Hospital, for Community Based Care and other healthcare settings.

Following an open procurement process and Government decision, Children’s Hospital Ireland have signed contracts with EPIC for the provision of an EHR System for the New Children’s Hospital. This will be the most extensive EHR deployment in Ireland and builds upon the success of EHR programmes at our largest maternity hospitals and St James’s Hospital.

The planned expansion of the use of electronic health records to maternity hospital sites at Limerick and the Coombe, in 2022 and 2023 will result in 70% of babies born in Ireland being assigned an electronic health record at birth. Contracts for clinical management systems capable of generating EHRs have also been signed for the National Rehabilitation Hospital and the National Forensics Hospitals.

For community-based EHRs, a formal market soundings exercise was completed in Q1 2022 and a business case is under development. Separately almost all GPs practices use accredited GP Practice Systems capable of generating EHRs for patients.

My Department is also giving consideration to a strategic approach to widening the roll-out of EHRs, interoperability of existing systems and market technology and systems advances in conjunction with the establishment of Regional Health Areas.

Hospital Facilities

Questions (107)

David Stanton

Question:

107. Deputy David Stanton asked the Minister for Health if a contractor has been appointed to construct the new building at Midleton Community Hospital; if so, when he expects work to commence; and if he will make a statement on the matter. [52359/22]

View answer

Written answers

As the Health Service Executive is responsible for the delivery of public healthcare infrastructure projects, I have asked the HSE to respond to you directly in relation to this matter.

Medicinal Products

Questions (108, 119, 123)

Jim O'Callaghan

Question:

108. Deputy Jim O'Callaghan asked the Minister for Health when the cystic fibrosis drug kaftrio will be available for all children; and if he will make a statement on the matter. [52162/22]

View answer

Gino Kenny

Question:

119. Deputy Gino Kenny asked the Minister for Health if the HSE has made kaftrio available to all adults and children who need the treatment; and if he will make a statement on the matter. [52400/22]

View answer

Duncan Smith

Question:

123. Deputy Duncan Smith asked the Minister for Health the status of the reimbursement pricing negotiations for the cystic fibrosis drug kaftrio as of October 2022; and if he will make a statement on the matter. [52377/22]

View answer

Written answers

I propose to take Questions Nos. 108, 119 and 123 together.

Kaftrio has been a life changing drug for Cystic Fibrosis sufferers, and I want to see it made available to everyone who needs it.

The HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drugs schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.

I have been advised by the HSE that engagement with Vertex Pharmaceuticals is ongoing, which I hope can be brought to a satisfactory conclusion for everyone.

I will be meeting with Cystic Fibrosis Ireland next week to hear their ideas for possible solutions. The meeting will include clinical experts and patient representatives, giving a voice to those with real world experience of this debilitating disease and the difference Kaftrio could make. I am optimistic that our meeting will be fruitful and contribute to making this drug available to every person who needs it.

Health Services Staff

Questions (109)

John Lahart

Question:

109. Deputy John Lahart asked the Minister for Health when the HSE will commence the process of prioritising the allocation announced in Budget 2023 of the 136 additional staff such as speech and language therapists, occupational therapists and physiotherapists to special schools; and if he will make a statement on the matter. [52186/22]

View answer

Written answers

As the Deputy's question relates to a service matter, it has been referred to the HSE for direct reply.

Health Services

Questions (110)

Seán Canney

Question:

110. Deputy Seán Canney asked the Minister for Health his plans to establish a national screening programme for structural heart disease; and if he will make a statement on the matter. [51147/22]

View answer

Written answers

I am fully committed to supporting our population screening programmes which are a valuable part of our health service, enabling early treatment and care for many people, and improving the overall health of our population.

It is important to be aware that any decisions about changes to our national screening programmes, or the introduction of new programmes, such as screening for structural heart disease, will be made on the advice of our National Screening Advisory Committee (NSAC). This independent expert group considers and assesses evidence in a robust and transparent manner, and against internationally accepted criteria. It is important we have rigorous processes in place to ensure our screening programmes are effective, quality assured and operating to safe standards, and that the benefits of screening outweigh the harms.

The Committee's first Annual Call in 2021 for proposals for new screening programmes or changes to our existing programmes, received a significant response with a total of 53 submissions received. Submissions were received from various sources and have been undergoing consideration by the committee at its scheduled meetings during 2022. The NSAC intends to publish its full work programme in the coming weeks.

I will be guided by their advice to ensure Ireland’s population-based screening programmes continue to evolve in line with new evidence and developments.

It is important to remember that population-based screening programmes are for healthy people without symptoms. If anyone becomes aware of symptoms, or if they have concerns or worries, they should contact their GP who will arrange appropriate follow-up care.

The National Review of Specialist Cardiac Services commenced in January 2018 under the Chairmanship of Professor Philip Nolan and a Steering Group formed from nominations of interested stakeholders representing medical, professional/technical staff, nursing and patient representatives.

The aim of the Cardiac Services Review is to achieve optimal patient outcomes at population level with particular emphasis on the safety, quality and sustainability of the services that patients receive, by establishing the need for an optimal configuration of a national adult cardiac service.

In terms of scope, the National Review covers scheduled and unscheduled hospital-based services for the diagnosis and treatment of cardiac disease in adults

The National Review of Specialist Cardiac Services is in the concluding stages and the Steering Group is currently working on the development of the proposed recommendations of the draft Report with the most recent meeting held on the 21st September 2022, and the next meeting scheduled for late October 2022. Any newly proposed population screening recommendations resulting from the review will be subject to consideration and advice of NSAC.

Vaccination Programme

Questions (111)

Jennifer Murnane O'Connor

Question:

111. Deputy Jennifer Murnane O'Connor asked the Minister for Health if he will provide more detail on his Budget 2023 commitment of €12.3 million to facilitate catch-up programmes for human papillomavirus vaccine to girls and boys at school and to women aged up to the age of 25 years in 2023; the estimated number of additional girls and boys in school and women up to age 25 years it is anticipated that this allocation will allow vaccinations to be provided for; if he will provide a breakdown on the way in which it is intended that this budget be used; if this budget is ringfenced for HPV or if it will be available for other vaccines; the start date for the funding allocation; the time period for which it will be dispersed; the locations in which the scheme can be accessed; the further programmes, if any, that he is considering to support vaccination in Ireland; and if he will make a statement on the matter. [51570/22]

View answer

Written answers

The immunisation programme in Ireland is based on the advice of the National Immunisation Advisory Committee (NIAC). The committee's recommendations are based on the prevalence of the relevant disease in Ireland and international best practice in relation to immunisation. It makes recommendations on vaccination policy to my Department. The NIAC continues to revise recommendations to allow for the introduction of new vaccines in Ireland and to keep abreast of changes in the patterns of disease. Therefore, the immunisation schedule will continue to be amended over time.

The Laura Brennan HPV Vaccination Catch-up Programme will offer free HPV vaccines to boys and girls in second level education who were previously eligible to receive the HPV vaccine and who have not yet, for whatever reason, received it.  Young women, up to the age of 25, who have now left secondary school, and who did not receive the vaccine, will also be eligible to receive the vaccine as part of the programme.

It is estimated that approximately 100,000 young people are eligible for the HPV catch up vaccination programme. These are the numbers who were previously eligible who did not receive any doses of HPV vaccine previously.

The allocated budget for this programme will cover all aspects of this nationwide campaign, including promotion, vaccine costs, administration costs and costs associated with information recording and reporting.

The HSE is currently working on the implementation plan for the Laura Brennan HPV Vaccination Catch-up programme, which is planned to launch in mid-November. Further details on the campaign and how eligible people can register their interest will be made available in due course.

Hospital Staff

Questions (112)

Seán Canney

Question:

112. Deputy Seán Canney asked the Minister for Health his plans to address the long waiting lists for treatment due to a chronic shortage of radiation therapists; and if he will make a statement on the matter. [51145/22]

View answer

Written answers

An independent review of the Radiation Therapist profession has been agreed under the auspices of the Workplace Relations Commission. Discussions are ongoing between the parties to finalise a Terms of Reference and appoint an independent chair.

As this is an ongoing Industrial Relations process it would be inappropriate to comment further at this stage.

Question No. 113 answered with Question No. 80.

Hospital Staff

Questions (114)

Niamh Smyth

Question:

114. Deputy Niamh Smyth asked the Minister for Health the steps his Department is taking in relation to concerns about a shortage in radiation therapists to carry out treatment in Ireland. [51505/22]

View answer

Written answers

Since the COVID-19 pandemic began, we have been committed to ensuring sufficient staffing levels to meet both COVID-related and long-term healthcare demand. There are 15,177 more whole-time equivalents working in our health service than there were at the beginning of 2020. This includes 4,500 nurses and midwives; 2,300 health and social care professionals; and 1,400 doctors and dentists.  The workforce is continuing to grow at a rapid pace and will continue into 2023.

In relation to radiation therapists, there are currently 208 WTE working in these grades in the Health service. This is an increase of 4.5% from pre-pandemic levels. 

While there has been significant growth, labour shortages of health care professionals has been a significant challenge. The HSE have expanded recruitment capacity and expanded the use of international recruitment markets to achieve the growth seen to date. We have directly targeted all of the 2022 health and social care professional graduates from Irish colleges and these applications are being interviewed currently. In relation to radiation therapists, an independent radiation therapist review has been agreed under the auspices of the WRC to consider issues including recruitment and retention. 

These recruitment and retention efforts will continue in 2023, with Budget 2023 securing funding for the expansion of 6 thousand additional whole-time-equivalents. These will include a significant number of health and social care professionals being added to the workforce.

Hospital Staff

Questions (115)

Colm Burke

Question:

115. Deputy Colm Burke asked the Minister for Health the current position in respect of the negotiations between his Department and the medical consultants' representative bodies in respect of the proposed new consultant contract; and if he will make a statement on the matter. [52294/22]

View answer

Written answers

The Government, as provided for in the Programme for Government, is committed to introducing the Sláintecare public-only consultant contract in a timely manner. The Department of Health along with the HSE has engaged with the Consultant’s representative bodies, the IMO and IHCA, through an intensive negotiation process on the new contract. The contract will not permit holders engage in private practice in public hospitals.

Engagement between the parties resumed on 23 June, following the appointment of a new replacement chair at that time, and is ongoing.

The introduction of the Contract is a key priority for me and the Government as a significant step in implementing Sláintecare reform and the delivery of care by consultants.

Hospital Services

Questions (116)

Matt Carthy

Question:

116. Deputy Matt Carthy asked the Minister for Health the engagements he has had with the RCSI Hospital Group with regard to expanding the operational opening times of the minor injuries' unit at Monaghan Hospital. [52117/22]

View answer

Written answers

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

Questions (117)

Willie O'Dea

Question:

117. Deputy Willie O'Dea asked the Minister for Health the number of the additional 23 specialist nurses in adult neurology services that will be allocated to the mid-west region; and if he will make a statement on the matter. [52417/22]

View answer

Written answers

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Assisted Human Reproduction

Questions (118)

Neale Richmond

Question:

118. Deputy Neale Richmond asked the Minister for Health if he will provide an update on when publicly funded IVF services will be made available; and if he will make a statement on the matter. [51384/22]

View answer

Written answers

As the Deputy might be aware, a commitment to “introduce a publicly funded model of care for fertility treatment” is included in the Programme for Government. The Model of Care for Infertility was developed by the Department of Health in conjunction with the HSE’s National Women & Infants Health Programme (NWIHP) in order to ensure that infertility issues are addressed through the public health system at the lowest level of clinical intervention necessary. This Model of Care comprises three stages, starting in primary care (i.e., GPs) and extending into secondary care (i.e., Regional Fertility Hubs) and then, where necessary, tertiary care (i.e., IVF, and other advanced assisted human reproduction (AHR) treatments), with patients being referred onwards through structured pathways.

Phase One of the roll-out of the Model of Care has involved the establishment, at secondary care level, of Regional Fertility Hubs within maternity networks, in order to facilitate the management of a significant proportion of patients presenting with infertility issues at this level of intervention. The completion of Phase One of the roll-out, envisaged before the end of this year, will result in fully operational Regional Fertility Hubs in each of the six Regional Health Areas across the country.

Phase Two of the roll-out of the Model of Care will see the introduction of tertiary infertility services, including IVF, provided through the public health system. In this regard, funding was secured in Budget 2023 to support access to advanced AHR treatments, including, crucially, to allow the commencement of Phase Two of the roll-out of the Model of Care.

This investment will facilitate the first steps to be taken towards the provision of a complete publicly-provided fertility service, which is the ultimate objective of Government. In particular, it will allow the historic development of the first National Advanced AHR Centre, delivering IVF and ICSI through a wholly public clinic. This is scheduled to open in the early part of 2024 and will provide a nationwide service, with all six Regional Fertility Hubs having equity of access for onward referral to it, via a shared care pathway. Subject to the provision of additional funding in future, it is envisaged that additional National Advanced AHR Centres will be developed and become operational on a phased basis elsewhere in the country.

The 2023 allocation will also be utilised to support the Regional Fertility Hubs in order to expand their scope of services next year by introducing the provision of IUI (intrauterine insemination), a significant, yet less complex and less intrusive, component of AHR treatment. 

Separately, as an interim measure, I have instructed that some funding be made available to support access to advanced AHR treatment via private providers from September 2023. 

My officials, in conjunction with NWIHP, are now planning for the operationalisation of both the publicly- and privately- provided service, including the development of a national eligibility framework, as well as determining how the interim funding for private treatments will be provided to individual eligible patients. 

Overall, my Department and the Government is fully committed, through the full implementation of the Model of Care for Infertility, to ensuring that patients always receive care at the appropriate level of clinical intervention and then those requiring, and eligible for, advanced AHR treatment such as IVF will be able to access same through the public health system. The underlying aim of the policy to provide a model of funding for AHR, within the broader new AHR regulatory framework, is to improve accessibility to AHR treatments, while at the same time embedding safe and appropriate clinical practice and ensuring the cost-effective use of public resources.

Question No. 119 answered with Question No. 108.

Health Services Staff

Questions (120)

Jennifer Carroll MacNeill

Question:

120. Deputy Jennifer Carroll MacNeill asked the Minister for Health if the HSE or hospitals have ever conducted exit interviews on doctors leaving the Irish medical system; and if he will make a statement on the matter. [51720/22]

View answer

Written answers

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

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