Written Answers Nos. 336-344
336. Deputy Bernard J. Durkan asked the Minister for Health the proposed best protection for vulnerable groups, including the elderly, within the public health sphere to ensure their protection to the best possible standard; and if he will make a statement on the matter. [2333/24]
View answerThe Health Service Executive (HSE) and the Health Protection Surveillance Centre (HPSC) regularly publish public health advice for older people and other service users on how to stay well and be protected, including publications on keeping well in winter and on vaccination, which are available online on HSE’s and HPSC's websites at the following web addresses:
• www2.hse.ie/living-well/winter/how-to-stay-well-in-winter/.
• www2.hse.ie/living-well/winter/advice-patients-with-chronic-conditions/.
• www2.hse.ie/screening-and-vaccinations/covid-19-vaccine/get-the-vaccine/.
• www2.hse.ie/conditions/flu/getting-the-vaccine/.
• www.hpsc.ie/publications/.
Protecting older or vulnerable patients and service users who may be at risk of abuse, harm, and neglect by others in the context of their interactions with the health and social care sector is a key objective of the Department of Health, every statutory body under its aegis, and every relevant service that interacts with such adults. In the health and social care sector, a framework of standards, policies and procedures for safeguarding adults who may be at risk of abuse, harm, neglect, and exploitation within the sector is in place, and further measures are being developed to strengthen this framework. The existing framework includes:
• the application within the health sector of relevant cross-sectoral legislation, for example in relation to reporting certain offences against children or vulnerable persons to An Garda Síochána, vetting, equal status and assisted decision-making;
• the significant regulatory powers of the Health Information and Quality Authority (HIQA) and the Mental Health Commission in relation to the quality and safety of healthcare and social care provision generally (under the Health Act 2007 and the Mental Health Acts);
• joint national adult safeguarding standards developed by HIQA and the Mental Health Commission, approved by the Minister for Health;
• the roles of health and social care professional regulatory bodies in relation to, for example, professional registration requirements and professional codes of conduct;
• a range of operational structures and procedures, including in particular the HSE’s national operational adult safeguarding policy Safeguarding Vulnerable People at Risk of Abuse – Policy and Procedures (2014).
The Department of Health remains committed to ensuring that the best possible safeguards are in place to protect any of our service users who may be at risk, and significant work is ongoing to develop health sector adult safeguarding policy and legislation, building on the robust structures already in place. The Department is at an advanced stage of developing a national policy to further strengthen existing protections in the health and social care sector. Draft policy proposals have been finalised and will be the subject of an imminent public consultation, details of which will be announced very shortly.
In addition, 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’. The Department of Health continues to develop a regulatory framework for providers. This will comprise primary legislation for the licensing of providers, secondary legislation in the form of regulations, and HIQA national standards.
Work is also ongoing on the drafting of legislation to enhance the oversight and regulation of nursing homes, which will include provision for a broader suite of enforcement tools for the Chief Inspector of Social Services. In addition, Nursing Homes Expert Panel funding has been provided for an increase of 18 posts in the HSE's nine Community Healthcare Organisation (CHO) Safeguarding and Protection Teams (9 Social Work Team Leaders, 9 basic grade Social Workers). All these positions have been funded for 2024 and all posts have been filled.
337. Deputy Bernard J. Durkan asked the Minister for Health the extent to which efforts are being made to replace GPs where the incumbents have retired leaving vacancies throughout the country; the number of such vacancies; and if he will make a statement on the matter. [2334/24]
View answerGPs are self-employed practitioners and therefore may establish practices at a place of their own choosing. There is no prescribed ratio of GPs to patients and the State does not regulate the number of GPs that can set up in a town or community.
Under the GMS scheme, the HSE contracts GPs to provide medical services without charge to medical card and GP visit card holders. Currently there are 2,518 GPs contracted to provide services under the GMS Scheme.
Where a vacancy arises in a practice with a GMS contract, the HSE becomes actively involved in the recruitment process to find a replacement GP. While recruitment is ongoing, the HSE put a locum or other suitable arrangement in place to provide continuity of care for the area concerned. As of the start of the December last, there are 23 GMS vacancies across the country, slightly less than 1 percent of the total number of GMS panels. 12 of the 23 GMS vacancies are in rural areas. It is acknowledged that certain vacancies can be difficult to fill, possibly due to location and/or the financial viability of smaller practices.
The Government has undertaken several measures to increase GP capacity and to improved access to services. The 2019 GP Agreement provided for increased annual investment of over €211 million for general practice, providing for increased GMS GP fees, supports and new services. A further €30 million has been provided for under the GP Agreement 2023 for practice supports to expand and retain practice staff.
The annual intake of doctors into the GP training programme has been increased by 80% from 2015 to 2023; there were 286 new entrants to GP training in 2023 and it is planned to increase the number of places for new entrants to 350 for this year. Furthermore, the joint HSE ICGP non-EU Rural GP Programme commenced last year with the intention of bring up to 100 non-EU GPs to Ireland in 2023, and it is planned to bring up to 250 more non-EU GPs here by the end of this year.
Of particular relevance, the GP Agreement 2023 provides for a pilot initiative on hard to fill GMS vacancies whereby GP services in an area with a suitable GMS vacancy would be provided by a nearby affiliated practice with hours of scheduled availability in the area agreed in advance with the HSE. The Strategic Review of General Practice, which is currently underway, is examining the broad range of issues affecting general practice, including issues related to GP capacity and the consideration of mechanisms to attract GPs to rural and urban deprived areas. When completed, the review will set out recommendation actions to deliver a more sustainable general practice into the future.
338. Deputy Bernard J. Durkan asked the Minister for Health the extent to which dental patients can have their requirements met and progressed as quickly as possible with particular reference to medical card holders; and if he will make a statement on the matter. [2335/24]
View answerThe Dental Treatment Services Scheme (DTSS) provides dental care, free of charge, to medical card holders aged 16 and over. Services available annually and on demand include an examination including preventative elements, two fillings, emergency extractions, and a scale and polish. More complex care, such as dentures, and a broader range of treatments for patients with additional needs and high-risk patients are available subject to the approval of the local HSE Principal Dental Surgeon.
Since May 1st 2022, there has been additional prevention treatments included and a 40-60% increase in fees paid to dentists across most treatment items. From January to October 2023, 142,450 additional treatments have been provided under the DTSS, with over 25,600 extra unique patients treated when compared with the same period in 2022.
I am aware that there are some towns with no or limited DTSS dentists that have sufficient capacity to accept new patients. Where access to a dentist is difficult, local HSE services assist patients who make enquiries and make lists of DTSS contractors available to medical card holders. In exceptional circumstances, the HSE assists patients to access emergency dental treatment by directly contacting private contractors or arranging treatment to be provided by HSE-employed dentists.
The Government is committed to fundamentally reforming dental services, including the DTSS, through implementation of the National Oral Health Policy, Smile agus Sláinte. My Department is working closely with the HSE to ensure the establishment of focused structures to drive implementation of the Policy. The HSE has now appointed a Strategic Reform Lead to drive Policy implementation across the organisation and to move forward in 2024 with developing new services for both adults and children in line with the Policy. This will include work on planning new services for medical card holders.
While it will take a number of years to bring reform to complete fruition, there will be an early emphasis in implementation on addressing the current issues, including the reform of the provision of services for medical card holders.
339. Deputy Bernard J. Durkan asked the Minister for Health to indicate the extent to which eligibility for medical cards for those diagnosed with serious or life threatening illness can be upgraded to take account of the individual circumstances of their case not based on financial eligibility but hardship grounds; and if he will make a statement on the matter. [2336/24]
View answerMedical Card provision is primarily based on financial assessment. In accordance with the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE, which assesses each application on a qualifying financial threshold.
The issue of granting medical or GP visit cards based on having a particular disease or illness was previously examined in 2014 by the HSE Expert Panel on Medical Need and Medical Card Eligibility. The Group concluded that it was not feasible, desirable, nor ethically justifiable to list medical conditions in priority order for medical card eligibility. In following the Expert Group’s advice, a person’s means remains the main qualifier for a medical card.
However, every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card and, in particular, to take full account of the difficult circumstances in the case of applicants who may be in excess of the income guidelines. The HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income threshold where they face difficult financial circumstances, such as extra costs arising from an illness. Social and medical issues are also considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services.
The HSE also has a compassionate system in place for the efficient provision of medical cards in response to emergency situations i.e., where persons are in need of urgent ongoing medical care or when a patient is receiving end of life treatment. In these cases, a medical card is issued within 24 hours of receipt of the required patient details and completed medical report by a healthcare professional. In addition, since March 2021, persons who have been certified by their treating Consultant as having a prognosis of 24 months or less are now also awarded a medical card on an administrative basis. This measure delivered the Programme for Government commitment to extend eligibility for medical cards to persons with a terminal illness and work is continuing to develop a legislative framework to underpin this administrative scheme. Medical cards awarded on end of life grounds are never re-assessed by the HSE thereby providing reassurance and comfort to patients and their families.
Separately, I can advise the Deputy that, since 2015, medical cards are awarded without the need of a financial assessment to all children under 18 years of age with a diagnosis of cancer. Further information can be found on the HSE’s website at www2.hse.ie/services/schemes-allowances/medical-cards/other-types-of-medical-card/emergency-medical-cards/.
I can assure the Deputy that, to ensure the medical card system is responsive and sensitive to people's needs, my Department keeps medical card issues under review and any changes are considered in the context of Government policy and other issues which may be relevant.
340. Deputy Bernard J. Durkan asked the Minister for Health the extent to which the various changes and requirements needed to fully introduce Sláintecare are being pursued at present; and if he will make a statement on the matter. [2337/24]
View answerThe shared vision of Sláintecare is to introduce a universal health and social care system where everyone has equitable access to services based on need, and not ability to pay. The Government is fully committed to the continued delivery of Sláintecare reform. Health Budget 2024 provided €22.5 billion to continue the delivery and expansion of quality, affordable healthcare services.
Significant progress was made in implementing the Sláintecare Strategy & Action Plan 2021-2023. Reform is helping to move healthcare delivery away from a hospital-centric system. Through Enhanced Community Care (ECC), a patient-centred population-based approach is integrating community care with the acute hospital sector, providing health services closer to people’s homes, and reducing pressure on acute hospitals. Work is now focused on designing patient-centred care models, and on developing better primary and community care.
Access to care has been increased through eligibility expansion, including an abolition of public inpatient hospital charges in 2023 and an extension of the free GP card to all children under 8. We have also recognised the need to improve and invest in infrastructure, including the development of new Elective Hospitals, as well as further developing our digital health offer.
The new Sláintecare Public Only Consultant Contract was implemented in March 2023 and will increase the number of senior decision-makers in our hospitals, including out of hours and at weekends. There are now more than 1,500 consultants on the new contract (more than 35% of the total number of consultants working across our health service). Significant investment has been made in tackling waiting lists and the average waiting time for outpatients reduced from 9.7 months to 7.5 months in 2023. The Sláintecare Integration Innovation Fund Programme identifies and promotes innovative and integrated models of care and new ways of working, with a view to mainstreaming or scaling successful projects. To date over 100 projects have been successfully tested and are receiving recurring annual funding.
A Final Report on implementation of the 2021-23 Strategy and 2023 Action Plan is in preparation and will be submitted to Government for approval. A successor Sláintecare Framework for 2024 to 2027 is at an advanced stage of development and will be published following Government approval.
The Sláintecare Programme Board (SPB) was established in 2021 to drive the reform programme and embed the Sláintecare principles into our health service. Reporting to the Minister of Health, the Board is co-chaired by the Secretary-General of the Department of Health and Chief Executive Officer of the HSE. The Board also comprises the joint leads of the reform projects from the Department’s Management Board and the HSE’s Executive Management Team. This structure provides interagency strategic leadership, oversight, and accountability for the delivery of the Sláintecare reform programme. The Minutes of the SPB meetings are published as a matter of course.
341. Deputy Peter Fitzpatrick asked the Minister for Further and Higher Education, Research, Innovation and Science what supports are available for part-time students; if he will expand on the eligibility criteria for the scheduled SUSI grant scheme due to be implemented in September 2024; and if he will make a statement on the matter. [1718/24]
View answerThe National Access Plan has called for more flexible forms of learning for target groups and those who are socio-economically disadvantaged. One of the priorities for Budget 2024 is reducing child poverty. We know that Education has the power to transform lives, lift people out of poverty and break down cycles of intergenerational poverty.
I have been consistent in my position that we need to develop our student support system over time to ensure that it supports more flexible forms of learning.
Through sectoral engagements, there is an increased recognition that supporting part-time and blended learning has the potential to increase access to learning in the medium term, once existing reform commitments are embedded within the sector.
The fees associated with part-time programmes are a key barrier to higher education access and the expansion of fee support to part-time students is a significant new initiative which will open the doors of higher education to many groups who could not participate in full-time programmes.
From September 2024, a pilot part-time fee grant will be available to provide support for students who are undertaking eligible undergraduate part-time programmes leading to a major award, both in-person, blended and online.
The Scheme will be means tested and available to those with reckonable income under €55,924 and will be subject to satisfying certain criteria.
The Scheme is currently under development. My Department is currently engaging in further discussions with key stakeholders and Higher Education Institutions and communication will be provided in the next few months on the new Scheme and how to apply when the parameters have been agreed.
342. Deputy Mairéad Farrell asked the Minister for Further and Higher Education, Research, Innovation and Science if he will provide details of the work his Department does with the Department of Enterprise, Trade and Employment, to ensure that students and apprentices transition into suitable employment opportunities; and if he will make a statement on the matter. [2288/24]
View answerIt is essential more than ever that our skills ecosystem has the agility and flexibility to adapt to changing priorities in the skills and workforce development landscape, with the backdrop of the accelerating and intensifying digital and green transitions. In this context, one of the key themes of the OECD Review of Ireland's National Skills Strategy published last May was the need to secure a balance in skills through a responsive, diversified supply of skills in Ireland.
The tertiary education system plays a central role in ensuring that our graduates from higher education, further education and training and from apprenticeship are equipped with the essential transversal skills, on top of vocational and professional skills and competencies that will equip them for success in work. These skills enhance their employability and ensure graduates have skills to adapt to diverse tasks and contribute meaningfully to the workplace and the society.
The agility and flexibility of the tertiary system is underscored by responsiveness to priority industry and enterprise workforce needs under key policy initiatives that require whole-of-government efforts and collaboration such as, for example; the Action Plan for Apprenticeship; Funding the Future; the Green Skills for FET Roadmap; and the National Digital Strategy Harnessing Digital. Those concerted efforts aim to improve balance between skills demand and supply.
A key aspect of FET courses is their focus on the needs of employers and industry developments, to ensure learners are equipped to gain employment following course completion. One of the strategic objectives of national Further Education and Training strategy is to support learner pathways within FET and progression to higher education courses, where relevant and a goal of the learner.
A key strength of the apprenticeship model is that it is a demand-led employer-driven approach to meeting workforce and skill requirements in our economy. As such, the demand for and number of apprentices is primarily dictated by employers and their needs in any sector. Apprenticeships are programmes of training in employment undertaken through a contract of employment. There is a clear connection established between skills demands and apprenticeship registrations in the economy that aims to address skills gaps and increase employability of graduates.
Overall employment rates for graduates remain at a historic high, with 83% of graduates in employment 9 months after graduation. Employment rates are highest for Education graduates (93.9%) followed by Health and Welfare graduates (88%) and ICT graduates (87.1%). Employment rates were lowest for graduates from the Arts and Humanities (66.3%) followed by Natural Sciences, Mathematics and Statistics (76.6%) and Social Sciences, Journalism and Information (77.8%)
Technological Universities generally have higher employment rates than Universities as more of their graduates go directly into employment rather than pursue further study. Between 82% and 87% of honours degree graduates from TUs are in employment nine months post-graduation, compared to 64% - 85% for Universities. TUS had the highest employment rate, at 86.9% while the University of Galway had the lowest (64.4%)
The Central Statistics Office also publish data on higher education outcomes, matching HEA graduate data against administrative data sources such as Revenue and Department of Social Protection records. The latest data published, which relates to outcomes for students who graduated in 2019 one year after graduation, found that 94% of graduates were still registered in employment, education or social welfare sources within the state
343. Deputy Alan Farrell asked the Minister for Further and Higher Education, Research, Innovation and Science what role his Department can play in easing the labour shortage in the construction sector; and if he will make a statement on the matter. [49042/23]
View answerA key government priority is to increase the number of people employed in the construction sector. This is essential to the Government meeting its ambitious targets under Housing for All.
The CSO Labour force survey of Q3 2023 shows when compared with pre-Covid levels of Q3 2019 the total employment in the sector has grown by 17,600. The Department works with sectoral partners such as SOLAS, to increase skills supply through the current network of skills provision available across the tertiary education system in order to tackle climate and housing issues. We are expanding the number of apprentices we train. There is a significant expansion of the education and training pipeline for construction-related courses. Development processes are in place for employers/sectors who wish to assess the potential for new apprenticeships. In recent years, annual intake in construction and construction-related apprenticeships has steadily increased. As of the end of December 2023, there have been 4.946 registrations on construction programmes and 848 registrations on construction-related programmes. Overall that is a 3% increase of registrations on 2022’s figures. This year the construction and construction related apprentice population has surpassed 20,000 for the year, again an increase on 2022’s figures.
Increased funding for apprenticeships increases the total capacity of the apprenticeship system and will reduce the time that apprentices wait for training. Budget 2024 provides €67m (€57m in core funding and €10m temporary) which will provide core investment into the apprenticeship system, and allow craft apprenticeship to continue to grow.
The Report on the Analysis of Skills for Residential Construction & Retrofitting 2023–2030 outlined our labour market requirement at over 50,000 new entrants into the construction sector for that period to meet our housing and retrofitting targets. This Department has put reporting and monitoring arrangements in place to ensure we are providing the appropriate skills response. In total there were 23 actions to be delivered on the report. The actions established the pathways to implement NZEB/retrofitting provision and training and begin the process of introducing MMC.
In particular the recommendations and actions arising from the report allowed us to look at recruitment. In August 2023, the Department published the Careers in Construction Action Plan. Its purpose is to explore the barriers to a careers in the construction sector in Ireland. The 20 actions in the plan are aimed at minimising barriers to construction careers, promoting career opportunities and making construction jobs more attractive to women. This involves changes in the sector, training and upskilling, and promotional activity. To assist in the promotional goals of the Action Plan, funding has been granted for a number of initiatives under the 2024 Housing for All Implementation Fund including a peer-to-peer social media campaign to recruit young adults to the sector and a documentary on working in the sector.
In terms of innovation, the greater adoption of MMC would be expected to lessen the projected increased need in labour demand so it is imperative that we continue to invest in projects such as National Demonstration Park in Mount Lucas.
With the Government’s commitments to Housing for All and the initiatives provided by the Department and partners, there are clear pathways to a career in construction, which will help to continue to promote opportunities in the sector.
344. Deputy Marc Ó Cathasaigh asked the Minister for Further and Higher Education, Research, Innovation and Science the progress in relation to the implementation of the Adult literacy for Life strategy through library activities, as actioned in the National Public Library Strategy 2023-2027; and if he will make a statement on the matter. [49681/23]
View answerLibraries are a key stakeholder in the Adult Literacy for Life (ALL) Strategy, the government’s 10-year adult literacy, numeracy and digital literacy strategy for Ireland.
The ALL National Programme Office engages regularly with the Libraries Development Unit, in the Local Government Management Agency (LGMA) on the strategy implementation and the LGMA (Libraries Ireland) is on the ALL Cross Government Oversight Group and the ALL National Literacy Coalition.
Many libraries across Ireland are also recipients of the Adult Literacy for Life Collaboration and Innovation Fund which supports people access the skills of literacy, numeracy and digital skills. This includes:
• Donegal Travellers Project ‘Trav Story Sacks’ in partnership with Donegal Library Service;
• Dublin City Libraries ‘Library Literacy Champions’ project in partnership with the National Adult Literacy Agency (NALA);
• Kildare County Council / Kildare Library Service: ‘Working Words: Social Engagement Literacy Project’ at Kildare Libraries in partnership with Kildare and Wicklow Education and Training Board.
• Kilkenny Library Service: ‘Literacy Together’ in partnership with Kilkenny and Carlow Education and Training Board;
• Leitrim County Library Service: ‘Digital Skills for ALL’ in partnership with Mayo Sligo & Leitrim Education and Training Board;
• Monaghan County Libraries: ‘TechKnow@ Your Library – A Digital Literacy Empowerment Programme’ in partnership with Cavan and Monaghan Education and Training Board;
• Waterford City and County Library Service: ‘Family Summer Camp – August Family Fun Fest’ in partnership with Respond Housing Association;
• Wicklow County Council Library service: ‘Lexia Power Up Licences for Adults Learning English as a Second Language’ in partnership with West Wicklow Adult Basic Education Service / KWETB.
Library representatives have been invited to join Regional Literacy Coalitions in their Education and Training (ETB) catchment area. The aim of the Regional Literacy Coalition is to drive the aims of the ALL Strategy at local level. Many Coalitions have had their first meeting in 2023, with more planned for 2024.
On the 11th January 2024, over 60 library staff and Regional Literacy Coordinators attended a briefing on the ALL Strategy. The purpose of the meeting was twofold. Firstly, to showcase and share innovative partnership projects that supported adults with unmet literacy needs, which were led by or involved libraries. Secondly to provide information to those attending about further ALL funding and other opportunities to work on ALL related projects in 2024. This includes the 2024 Collaboration and Innovation Fund and the ALL National Programme Office and Regional Literacy Coordinators support for the libraries Ireland Reads campaign in February and International Literacy Day in September.
The ALL National Programme Office and the Regional Literacy Coordinators will also be collaborating on the libraries’ national Skills for Life Umbrella Programme of resources and activities to be developed and rolled out under the Library Strategy by end 2024.
