Wednesday, 6 Dec 2023

Written Answers Nos. 156-173

Departmental Data

Questions (156)

Bríd Smith

Question:

156. Deputy Bríd Smith asked the Minister for Children, Equality, Disability, Integration and Youth the number of children currently on the waiting list to be seen by the Children’s Disability Network team in counties Carlow and Kilkenny; the length of time they have been waiting; the number of vacancies on the CDNT currently; if the recent HSE staff embargo means that these vacancies are not being advertised to be filled and/or will not be filled until the embargo is lifted; and if he will make a statement on the matter. [54198/23]

Written answers

Minister of State at the Department of Children, Equality, Disability, Integration and Youth

As this question refers to service matters, I have asked the Health Service Executive (HSE) to respond to the Deputy directly, as soon as possible. As the Deputy may be aware, the industrial action that commenced on Friday 6th October, by management and administrative grades in Fórsa Trade Union in the HSE, will impact on the response times to Parliamentary Questions and Representations.

Home Help Service

Questions (157)

Fergus O'Dowd

Question:

157. Deputy Fergus O'Dowd asked the Minister for Health if he will provide an update on the expected timelines on the establishment of a new statutory home support scheme; how he plans to scope and plan for such a scheme; and if he will make a statement on the matter. [53920/23]

Written answers

Minister for Health

The Programme for Government commits to ‘Introduce a statutory scheme to support people to live in their own homes, which will provide equitable access to high-quality, regulated home care’. Work is ongoing within the Department across four broad areas to progress this commitment: (i) Regulation of home-support providers; (ii) the examination of future funding options for home-support services; (iii) working with the HSE to develop a reformed model of service delivery for home support (iv) Implementation of the recommendations of the Strategic Workforce Advisory Group.

A key step in this process is to regulate home support services so that no matter where or how care is provided, service users can be assured that their provider meets minimum standards of quality. The Department of Health is currently preparing primary legislation to accompany regulations. Primary legislation has been prioritised for drafting in the Autumn Legislative Programme.

In order to help in drafting the legislation and regulations a public consultation was completed in August 2022. The department has also been consulting with HIQA, the HSE, legal counsel, and representative groups to help improve the regulations further. Regulations are now at an advanced stage. Legal advice and engagement with key stakeholders will assist with final revisions.

Funding Options: How home support will be funded in the future will be an essential factor of the new Statutory Scheme. With this in mind the Department is researching different funding models. The Economic and Social Research Institute undertook a programme of work on behalf of the Department on the potential demand and cost of home support which culminated in two reports:

www.esri.ie/publications/demand-for-the-statutory-home-care-scheme

www.esri.ie/publications/home-support-services-in-ireland-exchequer-and-distributional-impacts-of-funding

A rapid response from the European Observatory on Health Systems was commissioned and published in March of this year.

eurohealthobservatory.who.int/publications/i/improving-home-care-sustainability-in-ireland-are-user-charges-a-promising-option

This research will form an important part of the evidence base for the development of a sustainable funding model for home care services. No final decision on future funding has been made and further research is currently underway to enhance the evidence base.

Reformed Model of Service: In 2022 a Pilot for testing of a reformed model of service for the delivery for home care became fully operational in 4 Community Healthcare Organisations. Evaluation of the pilot has been completed.

The national roll-out of interRAI as the new standard assessment tool for care-needs in the community is underway. The HSE is in the process of establishing of a National Home Support Office. Four WTEs, including the Head of Service of the new National Home support Office, have been appointed.

In March 2022, Minister Butler established the cross-departmental Strategic Workforce Advisory Group on Home Carers and Nursing Home Health Care Assistants. It set out to examine the challenges in front-line carer roles in the home support and long-term residential care sectors.

The Report of the Strategic Workforce Advisory Group on Home Carers and Nursing Home Healthcare Assistants was published on 15 October 2022. It presents 16 recommendations to address these challenges. A group has been established to drive the implementation of the recommendations. The first meeting of the implementation group took place on 29 June 2023. Recommendation 9 has been fully implemented. The statutory instrument authorising the issuance of 1,000 employment permits for home care workers was signed in December 2022. These permits will be for full-time positions with a minimum salary of €27,000 per year.

Work is under way on all recommendations with a further four at an advanced stage. A new and improved HSE Home Support Tender has been in place since August. This delivers on commitments for sectoral reform such as payment for travel time for home support providers, paying carers the National Living Wage at a minimum, and bringing legacy rates in line with the new revised rates of funding.

It is envisaged that the implementation group will meet quarterly, with the next meeting scheduled for January 2024. An updated progress report of the Strategic Workforce Implementation Group on Home Carers and Nursing Home Healthcare Assistants was published in October 2023 which can be viewed below:

www.gov.ie/pdf/?file=https://assets.gov.ie/275876/c0889fbf-3f9c-4235-9e79-e1240790fac7.pdf#page=null

Vaccination Programme

Questions (158)

Róisín Shortall

Question:

158. Deputy Róisín Shortall asked the Minister for Health the status of the health technology assessment on the herpes zoster vaccine which also protects against shingles; and if he will make a statement on the matter. [53921/23]

Written answers

Minister for Health

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.

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.

Shingles vaccination is not currently provided as part of the national immunisation programme. Further information is available here: www2.hse.ie/conditions/shingles/

It is open to any individual who is aged 50 years and older and who wishes to receive the vaccine to consult with their GP or pharmacist.

It may be of interest to note that the Health Information and Quality Authority are currently carrying out a Health Technology Assessment (HTA) on the herpes zoster vaccine which protects against shingles. A HTA is a multidisciplinary research process that collects and summarises information about a health technology. The information can cover a range of fields, including clinical effectiveness and safety, cost-effectiveness and budget impact, organisational and social aspects, and ethical and legal issues. The information is collected and presented in a systematic, unbiased and transparent manner.

The outcome of the HTA, once it is complete, will inform future decision making on this matter in relation to whether or not any amendments are required to the National Immunisation Programme. The HTA is expected to be completed in the second half of 2024.

Health Services

Questions (159)

Ged Nash

Question:

159. Deputy Ged Nash asked the Minister for Health if he plans to ensure the integration of spinal muscular atrophy screening in the heel prick test before the end of 2024; and if he will make a statement on the matter. [53924/23]

Written answers

Minister for Health

The expansion of the National Newborn Bloodspot Screening (NBS) Programme continues to remain a key objective of mine as Minister for Health, and I am pleased to note that the National Screening Advisory Committee (NSAC) has been actively progressing work in this regard.

Significant progress has been made on the expansion of the NBS Programme over the past 18 months. As the Deputy will be aware, on 26 November I approved the recommendation from NSAC on the addition and Spinal Muscular Atrophy (SMA) to the NBS programme. This will bring the number of conditions screened for as part of what is commonly known as the ‘heel prick’ test in Ireland to 11, once the implemented.

I have written to the HSE requesting that they commence implementation planning for SMA, with work expected to begin on this shortly. Officials in my Department will continue to be available to assist the HSE in this regard.

The introduction of screening for SMA will enable earlier identification and diagnosis, thereby facilitating earlier disease management and treatment. I am acutely aware of how difficult it is for parents, families and children who have received a diagnosis of a rare disease, and how challenging daily life can be for them. Screening will make a real difference to their lives, which is why I am determined to see testing introduced for this condition as soon as possible.

Dental Services

Questions (160)

Seán Crowe

Question:

160. Deputy Seán Crowe asked the Minister for Health for a breakdown of the number of dentists enrolled with the dental treatment service scheme, by county, in tabular form. [53932/23]

Written answers

Minister for Health

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

As the Deputy may be aware, management and administrative grade staff in the Fórsa union in the HSE commenced industrial action on Friday 6th October. As a consequence of this industrial action, members in these grades are not engaging with political forums or processes. As a result, the question asked by the Deputy may be delayed in receiving a response directly from the HSE.

Health Services Waiting Lists

Questions (161)

Seán Crowe

Question:

161. Deputy Seán Crowe asked the Minister for Health the number of people currently on the waiting list for the Centre for Obesity Management; and the average waiting time to access services once a referral has been made. [53933/23]

Written answers

Minister for Health

It is recognised that waiting times for many scheduled appointments and procedures were too long before and have been made worse by the Covid-19 pandemic.

The Department of Health continues to work with the HSE and the National Treatment Purchase Fund (NTPF) to identify ways to improve access to care.

The 2023 Waiting List Action Plan builds on the foundational work done in the 2021 and 2022 plans, both of which reversed the annual trend of rising waiting lists.

For 2023, funding totalling €443 million is being allocated to tackle Waiting Lists with €363 million of this being allocated to the 2023 Waiting List Action Plan, to reduce hospital waiting lists by implementing longer term reforms and providing additional public and private activity to clear backlogs exacerbated during the pandemic. Bariatrics has been identified as a priority area in the Waiting List Action Plan with additional funding provided to expand this service. The remaining €80 million of the €443 million is being targeted at various measures to alleviate community/primary care waiting lists.

With the funding from Budget 2024 (€407 million), we are taking the next steps in the multi-annual approach towards achieving the vision of a world-class public healthcare system in which everyone has timely and transparent access to high-quality scheduled care, where and when they need it, in line with Sláintecare reforms.

In relation to the particular query raised by the Deputy, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

As the Deputy may be aware, management and administrative grade staff in the Fórsa union in the HSE commenced industrial action on Friday 6th October. As a consequence of this industrial action, members in these grades are not engaging with political forums or processes. As a result, there may be a delay in the Deputy receiving a reply from the HSE.

Healthcare Policy

Questions (162)

Seán Canney

Question:

162. Deputy Seán Canney asked the Minister for Health if he supports the calls of representative organisations and industry for a national diabetes policy to coordinate and direct diabetes policy; and if he will make a statement on the matter. [53948/23]

Written answers

Minister for Health

Diabetes is a complex condition that can require management across the entire spectrum of healthcare delivery, including self-management support as well as care delivered through general practice, community specialist care and hospital inpatient specialist care.

The planned delivery of diabetes services is ongoing. As part of Budget 2023, funding was allocated to implement a number of initiatives aimed at improving diabetes care. This includes the commencement of the development of a National Diabetes Registry, the commencement of a National Paediatric Audit of Type 1 Diabetes, and two further initiatives related to gestational diabetes.

The inclusion of diabetes as one of four chronic diseases in respect of which GMS patients receive ongoing, planned care from their GP through the Chronic Disease Management Programme also represents a major step forward in assisting those living with diabetes to manage their condition. As part of the recently published GP Agreement of 2023, agreement was secured to include all women who have been diagnosed with gestational diabetes or pre-eclampsia since January 2023 in the CDM Preventative Programme.

Guidelines for Diabetes prevention and management include the Model of Integrated Care for Patients with Type 2 Diabetes, the Model of Care for the Diabetic Foot (2021) and the National Clinical Guideline for the Management of Adult Type 1 Diabetes. Guidelines are reviewed and amended in line with the most up to date evidence to support best clinical practice and standardisation of care for diabetes patients.

In 2020, the Health Service Executive published The National Framework for the Integrated Prevention and Management of Chronic Disease (2020-2025) which adopted a whole system approach to integrated care for people with Chronic Diseases. It sets out a national framework for an integrated approach to the prevention and management of chronic disease in Ireland over the coming years. This framework was developed in relation to four major chronic diseases, including type 2 diabetes. The framework builds on the existing policies and guidelines, with a focus on health promotion, disease prevention, diagnosis, treatment, disease management and rehabilitation services that are coordinated across different healthcare providers and healthcare settings.

I am aware of the needs of the diabetes community and the challenges faced by those living with the condition. Officials in my Department engage with the HSE Diabetes clinical team in consideration of the future development of diabetes related services.

Legislative Process

Questions (163)

Seán Canney

Question:

163. Deputy Seán Canney asked the Minister for Health the timeline for the enactment of the Health Information Bill 2023; and if he will make a statement on the matter. [53949/23]

Written answers

Minister for Health

Background

The Health Information Bill will provide a legal framework to help create a fit-for-purpose, modern, digital-first health information system in Ireland which will support the care and treatment of patients. It will ensure that health information is available to patients and doctors at the right place and at the right time and it will also support better overall planning of our health services.

The Bill will be a key enabler of the new Digital Health & Social Care Strategic Framework in supporting the development of an integrated health information system. Importantly, the scope of the Bill applies across the spectrum of the health services - private, voluntary and public.

Timeline

The Government approved the General Scheme of the Health Information Bill on 18 April of this year and pre-Legislative scrutiny was concluded in July.

The Bill has priority status within the Office of the Attorney General and formal drafting is underway. My officials are working closely with the HSE and other stakeholders to support this work. The Bill is expected to be published in Q1 2024, after which its passage through the Houses of the Oireachtas will be scheduled.

Implementation will be on a phased and structured basis to ensure that the new health information framework and structures can be embedded successfully. Implementation timelines will also align with the overall timelines of the new EU Regulation on the European Health Data Space which is currently being negotiated and is the first sectoral data space to be established following the EU Data Strategy 2020.

Departmental Budgets

Questions (164)

Seán Canney

Question:

164. Deputy Seán Canney asked the Minister for Health the proportion (in percentage terms) of the annual health budget spent on medical technology and devices, from 2019–2023, broken down per annum, in tabular form. [53950/23]

Written answers

Minister for Health

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

Medical Qualifications

Questions (165)

Steven Matthews

Question:

165. Deputy Steven Matthews asked the Minister for Health if his attention has been drawn to the proposed changes (details supplied) to the qualifying criteria to become a psychotherapist put forward by CORU; if he is concerned of the impact this would have on the standard of patient care; and if he will make a statement on the matter. [53953/23]

Written answers

Minister for Health

As the Deputy will be aware, the Health and Social Care Professionals Council and Registration Boards, collectively known as CORU, are responsible for protecting the public by promoting high standards of professional conduct, education, training, and competence amongst the professions designated under the Health and Social Care Professionals Act (2005).

Each profession designated under the Health and Social Care Professionals Act has its own independent registration board with statutory responsibility for:

• Establishing and maintaining the register of members for that profession;

• Recognising qualifications gained outside the State;

• Approving and monitoring education and training programmes for entry to the register;

• Setting the code of professional conduct and ethics giving guidance to professionals on Continuing Professional Development (CPD).

The Counsellors and Psychotherapists Registration Board (CPRB) was established in February 2019. The work of the CPRB includes consideration of the titles to be protected and the minimum qualifications to be required of existing practitioners and the qualifications that will be required for future graduates. The work of the CPRB is significantly more challenging than it is for registration boards for some of the more established professions owing to the different and complex pathways into these professions, the variety of titles used, and the variety and number of courses and course providers.

To date, the following progress has been made by the CPRB:

• Identification, verification and comprehensive assessment of legacy/historical qualifications to determine if they are appropriate for transitioning existing practitioners onto the respective registers (when open);

• Scoping and research on the regulation of counsellors and psychotherapists internationally has been conducted;

• Drafting of separate and distinct draft Standards of Proficiency for counsellors and psychotherapists and Criteria for Education and Training Programmes has been finalised.

The public consultation on the draft Standards of Proficiency and Criteria for Education and Training Programmes ran until Friday 1st December 2023. As part of this consultation, the CPRB encouraged feedback from all stakeholders, including members of the professions, education providers, employers, professional and representative bodies, as well as members of the public.

I am informed that the CPRB will consider all submissions very carefully in formalising Standards of Proficiency and Criteria for Education and Training Programmes for the psychotherapy profession. CORU, on behalf of the CPRB, will brief my Department on the outcome of the public consultation in due course.

I hope this information is of assistance.

Health Services Staff

Questions (166)

Seán Sherlock

Question:

166. Deputy Sean Sherlock asked the Minister for Health to consider an exemption to the HSE recruitment freeze in the case of a person (details supplied). [53957/23]

Written answers

Minister for Health

As this Parliamentary Question relates to an operational issue, it is a matter for the HSE. However, members of the Oireachtas are advised that the HSE is currently not in a position to answer PQs due to industrial action. It is hoped that normal services will resume soon. In the meantime, this Department will continue to refer PQs to HSE for their direct reply as soon as possible.

Health Services Staff

Questions (167)

David Stanton

Question:

167. Deputy David Stanton asked the Minister for Health with reference to the current embargo on recruitment in the HSE, if a fully qualified and experienced nurse employed by the HSE and on a full-time contract, on returning from a career break, can resume working with the HSE again; and if he will make a statement on the matter. [53965/23]

Written answers

Minister for Health

As this Parliamentary Question relates to an operational issue, it is a matter for the HSE. However, members of the Oireachtas are advised that the HSE is currently not in a position to answer PQs due to industrial action. It is hoped that normal services will resume soon. In the meantime, this Department will continue to refer PQs to HSE for their direct reply as soon as possible.

Health Services Staff

Questions (168)

David Stanton

Question:

168. Deputy David Stanton asked the Minister for Health if the current recruitment pause in place in the HSE prevents the hiring of personnel such as cooks to fill vacancies which arise due to resignations; and if he will make a statement on the matter. [53984/23]

Written answers

Minister for Health

As this Parliamentary Question relates to an operational issue, it is a matter for the HSE. However, members of the Oireachtas are advised that the HSE is currently not in a position to answer PQs due to industrial action. It is hoped that normal services will resume soon. In the meantime, this Department will continue to refer PQs to HSE for their direct reply as soon as possible.

Primary Medical Certificates

Questions (169)

Niamh Smyth

Question:

169. Deputy Niamh Smyth asked the Minister for Health why a person (details supplied) cannot get a primary care certificate; and if he will make a statement on the matter. [53998/23]

Written answers

Minister for Health

To qualify for a Primary Medical Certificate, an applicant must be permanently and severely disabled within the terms of the Disabled Drivers and Disabled Passengers (Tax Concessions) Regulations 1994, and satisfy a range of conditions. Responsibility for the Disabled Drivers and Disabled Passengers (Tax Concessions) Scheme, operated by the Revenue Commissioners, falls under the remit of the Minister for Finance. To qualify for the scheme, an applicant must hold a Primary Medical Certificate.

The extent of the involvement of HSE personnel in the scheme relates to making a professional clinical determination as to whether an individual applicant satisfies the medical criteria set out in the Department of Finance regulations. This determination is undertaken by Senior Medical Officers for the relevant local Health Service Executive (HSE) administrative Community Health Organisation, on behalf of the Revenue Commissioners. These HSE personnel have no role in setting or amending the criteria.

A successful applicant is provided with a Primary Medical Certificate. An unsuccessful applicant can appeal the HSE's Senior Medical Officer's decision to the Disabled Drivers Medical Board of Appeal (DDMBA), which is under the auspices of the Minister for Finance.

Significant progress has been made to convene a new Disabled Drivers Medical Board of Appeals (DDMBA), with all five members now formally appointed by the Minister for Finance. It is expected that appeal hearings will recommence shortly.

Hospital Appointments Status

Questions (170)

Michael Healy-Rae

Question:

170. Deputy Michael Healy-Rae asked the Minister for Health the status of an appointment for a person (details supplied); and if he will make a statement on the matter. [54007/23]

Written answers

Minister for Health

Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.

In relation to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

As the Deputy may be aware, management and administrative grade staff in the Fórsa union in the HSE commenced industrial action on Friday 6th October. As a consequence of this industrial action, members in these grades are not engaging with political forums or processes. As a result, the question asked by the Deputy may be delayed in receiving a response directly from the HSE.

Health Services

Questions (171)

Fergus O'Dowd

Question:

171. Deputy Fergus O'Dowd asked the Minister for Health the total funding provided to each of the CHOs from 2016 to date with consideration of the highest population increase being in the CHO8 area (details supplied); if he is ensuring that the highest increased funding levels are being delivered in this catchment to meet the exponential demand; and if he will make a statement on the matter. [54009/23]

Written answers

Minister for Health (Deputy Stephen Donnelly)

I have referred this PQ to the HSE to provide details on the funding allocated to each CHO area. My Department allocates the budget to the HSE by service area. The HSE then prioritises the distribution of this allocation to each CHO area based on operational needs.

Hospital Transfers

Questions (172)

Patricia Ryan

Question:

172. Deputy Patricia Ryan asked the Minister for Health further to Parliamentary Question 230 of 22 November 2023, if he will provide further details of the process by which the decision will be made to discharge/transfer elderly patients who no longer need of hospital treatment to clinically appropriate nursing homes, and what if any, input the patient concerned and their loved ones/families may have into the location of that clinically appropriate nursing home placement; and if he will make a statement on the matter. [54012/23]

Written answers

Minister of State at the Department of Health

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

As the Deputy may be aware, management and administrative grade staff in the Fórsa union in the HSE commenced industrial action on Friday, 6 October. As a consequence of this industrial action, members in these grades are not engaging with political forums or processes. As a result, the question asked by the Deputy may be delayed in receiving a response directly from the HSE.

Departmental Funding

Questions (173)

Patricia Ryan

Question:

173. Deputy Patricia Ryan asked the Minister for Health if he will provide details and application criteria of the €10 million fund, as announced by him recently in Dáil Éireann, to enable small not-for-profits to be HIQA compliant; and if he will make a statement on the matter. [54015/23]

Written answers

Minister of State at the Department of Health (Deputy Mary Butler)

This new scheme is designed to target and support structural improvements in nursing homes under the standards published by the Health Information and Quality Authority (HIQA) for Regulation 27 (Protection against infection) and Regulation 28 (Fire precautions).

This scheme aims to improve the nursing homes standards under both these Regulations and assist them to meet their compliance plans outlined as part of their inspection process with HIQA.

The finer details of the scheme are being finalised, but I intend to announce the finalised plans for this new scheme shortly.