Gino Kenny
Question:80. Deputy Gino Kenny asked the Minister for Health the latest position on conducting a review of Covid-19 deaths in nursing homes; and if he will make a statement on the matter. [52402/22]
Ceisteanna Eile - Other Questions
Covid-19 Pandemic
In the Government's lifetime, will it conduct a review of all Covid deaths in nursing homes during the pandemic, in particular during the first 14 to 15 months? More than 53% of all deaths took place in that environment. I would like a public inquiry into this matter.
I express my sympathy again to all those who lost friends, family and other loved ones during the pandemic, including the many who were residents of nursing homes.
Since the start of the pandemic, the national response has continuously evolved to take account of emerging evidence and lessons nationally and internationally. Throughout, there has been a specific focus on older people, including those in nursing homes, and ensuring that the best possible protections are in place. Significant supports were put in place for nursing homes and the situation at national and local levels has been kept under ongoing and active review. As part of the Covid response, an independent nursing homes expert panel was established early in the pandemic to examine the management of Covid-19 in nursing homes. It provided real-time lessons and recommendations to inform the ongoing response. The expert panel reported to me in August 2020 and there has been significant progress and investment in implementing its recommendations.
I have stated previously that a review of the management and impact of Covid-19 in nursing homes is warranted. However, I have also said that I am aware that a review process, if done in the wrong way, would become lengthy and legalistic.
Ultimately, what matters here is that the families get the answers to the reasonable questions they are asking. We want to avoid a situation where that does not happen because everything becomes mired in legality, which has happened with others. That sort of process will not serve anybody. To that end, I have asked my officials to come back to me with options that provide a mechanism to address the questions the families have but to do it in a way that gets them answers in a timely manner. I will say more about that presently.
We all agree that fundamental mistakes were made during this period. What happened in the pandemic was unprecedented in Ireland and across the world. We had never seen it before in our lifetime. What the relatives want and deserve to know is what happened to their family members in their final weeks or days. I just cannot comprehend a situation in which one's mother or father is in a nursing home and there is no access for loved ones. There was panic in some instances. That situation warrants a robust inquiry or whatever the Minister wants to call it, whether a public inquiry or a review. A public inquiry is warranted in respect of the factors that led to so many deaths taking place in a nursing home environment. That is the question at hand. We can call the investigation whatever we want. I acknowledge inquiries have a bad history in this country in that they have been completely dragged out in the past. However, the relatives of those who died at least deserve some answers.
The relatives of those who died deserve the truth. Ultimately, that is what they are seeking and they have every right to it. We have to deal with the reality in this country of what happens when public inquiries are set up. What tends to happen is that everyone involved goes and gets lawyers. People go straight to the High Court and get injunctions stating they cannot be questioned and have their good name damaged. One ends up with a very legalistic process. That is why we have had things like tribunals in the past. Unfortunately, many of them, as we know, have gone on for years and do not always do what the people who matter in them want, which is to provide them with the truth. They can take years and put a huge stress on people's lives.
A model we have seen that worked very well was in the case of the inquiry into CervicalCheck, which involved bringing in Dr. Scally. That was not a public inquiry but it is fair to say most of us in here thought it worked and delivered. Maybe it did not deliver everything everyone wanted but it delivered a lot and, critically, it did so quickly.
I agree with the Minister that we do not want a dragged out process where, at the end of the day, it is the barristers and solicitors who are enriched. The special Oireachtas committee on this issue recommended that a public inquiry take place. That committee had a lot of respect and was thorough in its investigation of events, particularly in the first 14 months.
The other question that has to be answered concerns the composition of nursing homes in Ireland. Twenty years ago, they were 80% public but that is now reversed. The composition is unhealthy. It would seem private nursing homes were not equipped for this outbreak. The pandemic killed more than 1,000 people in the first 14 months in that environment. Systematic mistakes were made in regard to all the deaths that took place.
I agree with the Minister that families need the truth. Does he agree they also need accountability and closure? The fact is that 23 of these thousands of deaths in Ireland happened in a nursing home the HSE took over. Exceptional issues arose in Dealgan House that drove the HSE to move in and take it over. There was a complete collapse of the system there, including healthcare and governance. There was an appeal at one stage to bring in the Army.
The Minister cannot sit there and deny that if these were children, we would have had our inquiry by now. That is a fact. It seems that because these were older people and because many of them would have had dementia and were probably in the end stage of life, somehow this does not matter to the Government. It must matter. The Minister must find a way. We spent billions of euro fighting Covid, rightly and properly, but he has spent nothing on investing in finding a solution to this issue. What he is saying today is what he said to me previously on at least two other occasions. He has to take charge of this. He has to act. The families are entitled to closure, respect and truth from the Government.
The families of the 23 people who died in Dealgan House deserve an answer. The Minister said we do not want a process that is too long. It has already been too long. He spoke to the families and told them there needed to be a mechanism. It is shocking we do not have that mechanism at this point in time. We need it as quickly as possible. It is totally correct that we need to ensure learnings are taken on board, the families get the truth and there is accountability. We do not know what the future will be in respect of pandemics and future healthcare. We need to ensure this all happens as quickly as possible. Both the Minister and the Taoiseach have spoken about how public inquiries do not work and a commission of inquiry will not work. We soon need to see the system they are going to employ to provide these families with the answers they need. We need it as soon as possible and I implore the Minister to deliver it as quickly as possible.
I recognise the ongoing advocacy from the Deputies on this issue. I ask Deputy O'Dowd to reflect on a charge he has made here today. I do not think it is worthy of him. I take that charge very seriously and I ask him to-----
If it is helpful, I am not charging the Minister personally with that at all. What I am saying is that if these were children, we would have had the inquiry because public opinion would have demanded it. However, I withdraw anything in my statement that caused any offence the Minister may have felt.
I thank the Deputy. Like him and all of us, I take all of these lives seriously, regardless of anyone's age or anybody's background. That has nothing to do with it. I have met the families from Dealgan House and I have committed, and am happy to reiterate that commitment, to assist them in seeking answers to what happened to their loved ones. They have every right to that.
The difficulty we all face as legislators, in this one example, is that we all know there are multiple ongoing court cases. A voluntary process is difficult because I imagine those who we would want to be involved will take legal advice that says, "You are in court; therefore, do not participate in anything." What, then, do we do? We potentially move to a statutory investigation. Again, this is something that can be looked at but we all just need to be clear ourselves. We know statutory inquiries often tend, as Deputy Kenny said, to enrich one group of people and not get answers for the people who matter most. I am trying to find some mechanism that delivers for the families without it taking years of their lives and potentially failing them, which a formal statutory inquiry could result in if we get it wrong.
Covid-19 Pandemic
Steven Matthews
Question:81. Deputy Steven Matthews asked the Minister for Health the reason employees from an organisation (details supplied) and other section 39 organisation workers were excluded from the Covid-19 special recognition payment; and if he will make a statement on the matter. [52466/22]
Some workers in section 39 organisations were not included in the group receiving the special Covid-19 recognition payment. I realise the Minister has made statements previously on this issue. The group I am particularly inquiring about is Acquired Brain Injury Ireland, the staff of which worked in similar or the same conditions as those workers who were included in the payment. Will he clarify the rationale for why some groups had to be left out of the payment?
I thank the Deputy for his question. To recognise their unique role during the pandemic, the Government announced the recognition payment for eligible healthcare workers. Eligibility guidelines are required. Those guidelines, as they apply to the HSE and section 39 organisations, are on the HSE website. I am happy that more than 124,000 workers have been paid. We are fast-tracking those who remain to be paid, including workers in the Defence Forces, the fire brigade, prison nurses and others, the majority of whom are nursing home staff. I have engaged with the HSE and, in fairness to the executive, good progress is being made on that.
The other cohorts covered are agency workers within the HSE, healthcare support assistants contracted to the HSE, members of the Defence Forces deployed to the HSE and paramedic staff, as I mentioned earlier.
The Deputy raised a query relating to Acquired Brain Injury Ireland. It is not possible at this time to comment on individual cases but if workers meet the criteria as set out, they must and will be paid for that. If they do not meet the criteria, they will not be paid. He raised a good question as to why one group but not another, and why one group of healthcare professionals and not another. Those working in general practice, for example, were not covered and people reasonably asked the question on that. Ultimately, the Government had to set criteria. We expanded them quite significantly beyond what was envisaged. However, ultimately, there have to be some criteria around the payment. I hope that the workers to whom the Deputy referred meet the criteria. For those who do, I am in intensive engagement with the HSE at the moment about getting these remaining workers paid as quickly as possible.
I thank the Minister for his response. It is positive that 124,000 people have been paid in recognition of the tremendous work that they did during the pandemic. It is not an overstatement to say that many of us owe our lives or the lives of family members and friends to the work that was carried out by those organisations. I am glad that the Minister is progressing the payment for the other front-line emergency services workers who worked so hard and such long hours during the pandemic.
With regard to eligibility, is it up to the individual who works in an organisation to apply to say that he or she meets the criteria? I am aware that within an organisation there may have been people who were working in certain environments where they feel that they did meet the criteria and maybe some in the organisation who were not in situations that meet the criteria. Is it up to the individual or the parent body to make the application on his or her behalf?
It is being done organisation by organisation and, therefore, there is nothing that any individual has to do. The HSE is engaging directly with the section 39 organisations. It has service level agreements in place with a great many of them. Through them, it is engaging with the organisations. The HSE is providing them with the criteria and identifying the organisations that qualify. Those organisations are then identifying the workers who qualify.
I thank the Minister for the clarification. Essentially, this negotiation, as it were, is taking place between the HSE and those organisations. I might follow up this inquiry with the HSE directly just to support the particular worker to whom I referred. The case he has put to me seems to fit exactly with workers who were working in the exact same situation and are eligible for the payment. There are always demands on government. I understand that a line has to be drawn in respect of funding, criteria and eligibility. It is just that I have looked at this particular case, and I feel that the worker has a real case to make here, along with his colleagues who worked in the same environment. I am glad that the payments are being rolled out and that the Minister is following up on that, and that those who have not been paid so far will be paid in a timely manner. I will follow up with the HSE directly on behalf of this constituent.
I acknowledge that when we are trying to make a payment, which is a €1,000 tax-free payment that does make a difference to people, there is no amount that could fully recognise the work that people have done. However, it is a recognition and it is good by international standards, compared to what other European countries have done. There is no doubt that there are going to be workers who do not meet the criteria as set out but who deserve it. There is no doubt that there will be people who have actively helped patients and who, individually, we would say deserve the payment and if one group has got it, then this group deserves it as well. It would not be possible to design criteria to identify every worthy person. For example, many of the workers in general practice have a strong case, yet they were not included. The final thing I will say, and it is easy for me to say this, is that there is nothing preventing any employer from making a payment to their staff in recognition of the work they have done.
Question No. 82 taken with Written Answers.
Legislative Programme
Duncan Smith
Question:83. Deputy Duncan Smith asked the Minister for Health if he will provide an update on when the Health (Assisted Human Reproduction) Bill 2022 will be brought back before Dáil Éireann for its next Stage; and if he will make a statement on the matter. [52374/22]
I have a very simple question about what is a complicated Bill. When will the Health (Assisted Human Reproduction) Bill 2022 be brought back before us on Committee Stage? It has been a number of months since we had the Second Stage debate. Given the announcements that were made in the budget on IVF treatment, which were most welcome, I would appreciate some clarity on when the Bill is going to come back to us.
I thank the Deputy for his ongoing advocacy in getting the Bill across the line as quickly as possible. The Health (Assisted Human Reproduction) Bill 2022 passed Second Stage in the Dáil in March, as he will be aware, and was referred to the Oireachtas Select Committee on Health for Committee Stage. The legislation encompasses the regulation, for the first time in this country, of a wide range of assisted human reproduction, AHR, practices. It is important legislation. The published Bill provides for domestic altruistic surrogacy but not the regulation of surrogacy arrangements undertaken in other jurisdictions. However, we have the report of the special Oireachtas Joint Committee on International Surrogacy. The Ministers for Justice, and Children, Equality, Disability, Integration and Youth and I met immediately after that committee provided its report, and we asked our officials to come back to us as a matter of urgency with options and draft legislation on the recommendations. What I want is a comprehensive set of amendments for Committee Stage that reflect the surrogacy recommendations insofar as Government decides on those. I would like it to be done by the end of the year. That is what we are trying to achieve. There is ongoing engagement at ministerial and departmental level on that. As the Deputy will be aware, besides the surrogacy amendments, the Health (Assisted Human Reproduction) Bill is important in and of itself. I want that Bill through all Stages in this Dáil session. There are many reasons for that, one of which is IVF. We will move to the provision of publicly funded IVF for the first time next year. I am talking to our own HSE fertility clinics about hiring the new staff to provide all of those new services. To do that, the sector must be regulated. I want the Bill through all Stages in this session, of which there are probably eight weeks left. I would also like as broad an inclusion of the surrogacy recommendations on Committee Stage as possible.
That is a welcome response. As I said, the announcement in the budget of the first publicly funded IVF treatment in the country is a landmark announcement. We need to see that happen. The nature of this area impacts people who very much have time on their minds. Every Dáil session that goes by is a six-month period in people's lives. The Minister knows what I am saying. We are also hearing an increasingly coherent and strong voice coming from practitioners and medics in this area. I know that they have engaged with the Minister and have sent position papers to him, as they have to Opposition spokespeople. They have set out a wide range of recommendations on surrogacy and posthumous reproduction and on ensuring that the primary legislation does not restrict in any way, through its language, the development or use of ever-changing and ever-evolving treatments. There is a lot to take on there. If we can get this done by the end of the session, it would be most welcome.
I wish to make two points. The first is that in terms of what we want to amend, we have talked about surrogacy looking into the future, but there is also an issue about retrospective recognition, and parental recognition in respect of surrogacy arrangements undertaken prior to this Bill. That is something we have to do. I want that brought in, if at all possible, through Committee Stage amendments. There are children and parents out there today to whom we will, and must, provide that certainty around parentage. This is going to be a mechanism to do so. On the point the Deputy raised in respect of the AHR professionals group, it submitted a position paper setting out 12 recommendations. My officials have been meeting with them. Where there is agreement, we will also draft some substantial Committee Stage amendments to the AHR Bill, besides the surrogacy bit, to that end.
That is welcome. It is great that the Minister's officials are meeting with them. Perhaps he can find some time in his schedule to meet with them as well at some point this session.
It would be useful for him and it would be good for the legislation itself.
It was great to hear the Minister speak to a concern I raised on Second Stage, that is, regulating parents who, in the most simple terms, are unable to give permission for a childcare provider to give Calpol to their child because they do not have that standing. I am glad this question was picked out because we need to keep the pressure up to ensure the progress of this legislation, which is complex but important. We need to get it through with the right combination of speed and detail. I think we can get that done before the new year and I hope it will be done before Christmas.
I welcome the news announced by the Minister. I was honoured to be on the Joint Committee on International Surrogacy. There was a lot of work involved and we heard many families speak about their children. I am delighted the Minister is now working with other Departments to get the legislation through as soon as possible. That is important and it is good news. I also welcome that publicly funded IVF treatment will be available for the first time for families who need it. It is important that the Minister has given us a date. I am delighted he has been working with other Departments to allow for clarity.
I thank both Deputies. I am more than happy to meet representatives of the AHR professional group. They are having important meetings with the officials at the moment. It is a technical matter, clinically and legislatively, and they are working through that. I gather they are having a good engagement. Of course, I am very happy to meet representatives of that group.
In response to Deputy Murnane O'Connor, we are taking this on and moving it as quickly as we possibly can. I am advised that Ireland will be leading the world when this legislation is in place. The advice I have is that no other country in the world is seeking to legislate at this level. It is ethically and legislatively complex. The two Ministers, Deputies McEntee and O'Gorman, and I have asked our Departments to do what would normally take several years in several months. This is legislatively complex. We are pushing as hard as we can to get as much as we can into the assisted human reproduction Bill and, to Deputy Duncan Smith's point, to pass the Bill in the next eight weeks.
Health Services Staff
Willie O'Dea
Question:84. Deputy Willie O'Dea asked the Minister for Health the number of children's disability network teams, CDNTs, in community healthcare organisations, CHOs, 3 and 5; the locations in which each team is based; the numbers of staff in whole-time equivalent, WTE, terms approved for each team; the numbers currently assigned to each team; the number of vacant positions on each team; and if he will make a statement on the matter. [52416/22]
How many CDNTs are in CHO 3 and CHO 5? Where are each of the teams based? How many staff in WTE terms are approved for each team? How many are currently assigned to each team? How many vacant positions are there in each team? I ask the Minister of State to make a statement on these matters.
I thank the Deputy for raising this question. I will be giving a lot of figures so I hope he has a biro. There are seven and 12 children's disability teams in the areas the Deputy asked about. In CHO 3, there are seven and in CHO 5, there are 12. One of the seven teams in CHO 3 is HSE-led and the rest are led by our partner organisations. I will go through the statistics for CHO 3 first. In Blackberry Park, the lead agency for which is Enable Ireland, the vacancy level is 10%. In Clare, where there is a HSE team, the vacancy level is 12%. In east Limerick, where the Daughters of Charity is the lead agency, the vacancy level is 4%. In south Limerick, where St. Gabriel's is the lead agency, there is a vacancy level of 88%. That is a new team that has just formed so we are not to be alarmed by that figure. In north Tipperary, which will be of particular interest to the Deputy, Enable Ireland is the lead agency and the vacancy level is 38%. In The Treehouse, where St. Gabriel's is the lead agency, the vacancy level is 7%. In west Limerick, where the Brothers of Charity is the lead agency, the vacancy rate is 3%.
I will move on to Carlow, and I see Deputy Murnane O'Connor is in the Chamber and will be interested to hear some of these figures. Ten of the 12 teams in Carlow are HSE-led. I will go through the list. In Carlow, the HSE is the lead agency and the vacancy rate is 23%. In Cashel, the HSE is the lead agency and the vacancy rate is 20%. In Clonmel, the HSE is the lead agency and the vacancy rate is 37%. In Dungarvan west, the HSE is the lead agency and the vacancy rate is 54%, which is extremely concerning. In Enniscorthy, the HSE is the lead agency and the vacancy rate is 41%. In Gorey, the HSE is the lead agency and the vacancy rate is 41%. In Kilkenny, Enable Ireland is the lead agency and the vacancy rate is 9%. In New Ross, the HSE is the lead agency and the vacancy rate is 55%, which is extremely concerning. In Thomastown, the HSE is the lead agency and the vacancy rate is 28%. In Waterford north city, the HSE is the lead agency and the vacancy rate is 32%. In Waterford south, the Central Remedial Clinic is the lead agency and the vacancy rate is 29%. In Wexford, the HSE is the lead agency and the vacancy rate is 40%.
The vacancy rates for individual CDNTs are available. The latest HSE national CDNT and workforce review from April this year states that CHO 3 has an improved CDNT staff complement of 163 whole-time equivalents. Of those posts, 140 have been filled.
I will allow Deputy Murnane O'Connor to talk about Carlow and Kilkenny. The three figures the Minister of State shared in respect of Tipperary are extremely concerning. There are vacancy rates of 38% in north Tipperary, 20% in Cashel and 37% in Clonmel. Those are disturbing figures. There is no way to have an effective operation with vacancy rates such as those.
CDNTs are only staffed to approximately 50% of the level required, according to Professor Malcolm MacLachlan, clinical lead for people with disabilities at the HSE. Will the Minister of State update the House in that regard? Have we plans to try to increase staffing levels in those vital teams?
I thank the Deputy. I agree that the vacancy levels in north Tipperary, Cashel and Clonmel are concerning. There is no denying that whatsoever. There are plans afoot within the HSE for a progressive recruitment plan. It is only to do with CDNTs but applies across the disability sector. We have looked within and outside Ireland as a part of that recruitment campaign. We are flushing through all the panels to ensure that people can be recruited in as timely a process as possible. I note that where our lead agencies are left to do the recruiting, they are quicker and more timely and efficient. It is areas where the HSE is the lead agency that have large deficits. Our partners in the delivery of disability services have a much quicker recruitment process and are capable of recruiting.
I know how hard the Minister of State is working but I can only say that we have enormous issues in Carlow. The CDNT in Carlow has over 200 children on its waiting list for autism assessment. I understand that children are taken off the list by the CDNT per date order unless prioritised as a high risk. I can correct that if need be but that is my understanding. I am sure the Minister of State will correct me if I am wrong. These children are getting lost in the system. It is important that we get these assessments done. The Minister of State knows the importance of timing for children's assessments. I ask her to come back to me on that point. I also ask that we get as many assessments through as quickly as possible.
While she is here, I will say to the Minister of State that I have submitted parliamentary questions about primary care in Tullow for the past five years. I cannot even get word from the HSE about the whereabouts of the site. I am told funding is available. Perhaps the Minister of State will come back to me on that matter. I know she will.
In respect of the assessments of need, which the Deputy has raised, I was fortunate, with the help of my good colleague, the Minister, Deputy Stephen Donnelly, to secure €11.5 million to address the backlog for assessments of need. The last time I got such funding, we managed to clear that backlog. However, it is no good clearing the backlog unless we have a proper process for the timely delivery of interventions. To that end, the funding has now been secured and the plan has been put in place for delivering and administering the service across the country. There are concerns in respect of CHO 5, and I say that openly. Ten of the 12 teams in the area are HSE teams. They have a good opportunity to recruit. They are able to recruit into mental health and services for older persons. They are able to recruit into primary care. I must continuously ask them why we cannot do the same in the disability sector.
Question No. 85 taken with Written Answers.
Departmental Funding
Danny Healy-Rae
Question:86. Deputy Danny Healy-Rae asked the Minister for Health if he will address the crisis in the shortage of funding to deal with the provision of section 39 services (details supplied) that are struggling to continue to provide the necessary services for children and adults. [38903/22]
I respectfully ask the Minister to address the crisis in respect of the shortage of funding to deal with the provision of services by the Kerry Parents and Friends Association as section 39 workers who are struggling to continue to provide necessary services for children and adults with intellectual disabilities.
They do specialised, challenging work and operate to the highest standards. On top of everything else, they have not been paid the Covid-19 bonus payment of €1,000.
I join Deputy Danny Healy-Rae in acknowledging the extraordinary work that Kerry Parents and Friends Association provides. It provides critical services to adults with intellectual disabilities in the Deputy’s constituency, including day services, residential services, respite and outreach services. I am advised that the association has identified funding challenges to the HSE due to the changing service user needs, specifically the additional home supports that they are providing. I understand the association is currently facing issues in fundraising to supplement the current HSE funding.
It is relevant to say that the HSE - or the State or Government - currently funds the association to the tune of €13.6 million, so there is a significant amount of Government funding allocated to the association for the fantastic work it does. Discussions on all these issues are ongoing with the disability team in CHO 4. It is also relevant to point out that this organisation was one of the first 50 section 39 organisations to benefit from the first phase of the pay restoration since 2019. As the Deputy will be aware, there has been an ask for pay restoration in line with the financial emergency measures in the public interest, FEMPI, legislation from the section 39 organisations. The Government started with 50 organisations, based broadly on size and some other criteria, and the association was in that first group of 50. I know that has made a big difference.
More generally, I am mindful of the significant challenges faced by section 39 organisations right throughout the country. They are funded by the Government to provide vital services to communities in the areas of disability, mental health, older persons, palliative care, social inclusion and other areas. Energy and transport costs, as well as wider inflation pressures, are presenting specific issues. To that end. the Government has created a €100 million fund for this winter and organisations such as this will be recipients of funding from that allocation.
I appreciate that talks have taken place and further talks are to take place. I look forward to that. As section 39 workers, these staff are not fully funded by the HSE. This impacts the Kerry Parents and Friends Association because it is operating on an extremely tight budget and funds from fundraising are often used towards the costs of service provision. Pay parity is also an issue with the recruitment of new staff as the association cannot compete with or offer the pay available to section 38 workers. The Kerry Parents and Friends Association has 350 workers operating from 30 centres throughout Kerry doing tremendous work providing day services, residential services, respite, home support and outreach. Its staff pick up people with intellectual disabilities by bus and bring them into the centres for the day. They do tremendous work and I feel they are not being appreciated. The Kerry Parents and Friends Association continues to be committed to delivering these services and supports related to the needs, wishes and choices of the people with these intellectual disabilities in their communities in places like Killarney, east Kerry and throughout County Kerry.
I assure the Deputy, on my behalf, on behalf of the Minister of State, Deputy Rabbitte, who has responsibility for disabilities, and on behalf of the Government, the work the association in Kerry does is acknowledged and hugely appreciated.
Over €13 million of funding from the Government is provided to the association for the fantastic work that it does. On top of that, it was one of the first section 39 organisations in the country to benefit from increased funding for FEMPI reversal or de facto FEMPI pay reversal. Furthermore, it will be among the recipients of funding from the €100 million fund. The Minister of State, Deputy Rabbitte, is looking at between €60 million and €65 million from that fund for disability services and exactly the kinds of activities the Deputy has rightly raised. Energy costs, transport costs and bringing children and adults from home to services are exactly the kinds of areas on which I, the Minister of State and the Government want to support these organisations through this energy crisis.
Approximately €60 million of extra funding for disabilities was announced in the budget. How is this to be divvied out? Will it be used to bring pay parity to these section 39 workers, especially the staff of the Kerry Parents and Friends Association? The association has operated these services since 1978 and the individuals who work in it are suffering because of the increase in the cost of living, as is everyone else, and they are being left behind. There is a shortfall in funding for the Kerry Parents and Friends Association and I ask the Minister to address it. I appreciate that discussions have taken place and further discussions are to take place. However, I am also asking the Minister to ensure that these valuable people get the €1,000 that has been paid to other staff in other sections of the HSE. They are definitely entitled to it, without a shadow of a doubt.
Section 39 workers do the very same work as section 38 workers. Why is a distinction made between them? All over the world, people fight for equal rights. I am asking that the same rights be given to these section 39 workers, especially in the Kerry Parents and Friends Association in Killarney.
With regard to the funding for this winter, there is a service level agreement in place between the association and the HSE. This will be used with this section 39 organisation and all the others to determine their portion of the €60 million to €65 million provided just for the disability sector. That is a very significant amount. Broadly, the organisations will be able to use that money as they see fit to deal with energy costs. Of course, there will be guidance around that but that is the mechanism that is being worked through at the moment.
With regard to the special recognition payment, I have had intensive engagement with the HSE and it is mobilising to fast-track the payment to the section 39 workers. It may be the case that some of the workers, for example, those who are working in residential services, would get it because they are covered by the recognition payment. There are clear guidelines in place for who will get that. For everyone who meets those guidelines, I have asked the HSE to fast-track those payments.
They should all get it.
Questions Nos. 87 and 88 taken with Written Answers.
Dental Services
Duncan Smith
Question:89. Deputy Duncan Smith asked the Minister for Health his plans to address the issue of backlogs in dental treatment for primary school children and the need for urgent recruitment of dentists; and if he will make a statement on the matter. [52376/22]
I raise a question about our public dental system, particularly as it relates to primary school students. The system has collapsed. The waiting times, in areas where they even exist, are too long. They are longer than the time children spend in primary school. What is the Minister’s plan to address this? We have spoken about dental treatment before and the difficulties and challenges in the dental service. I would like to hear the Minister’s answer.
I thank the Deputy for raising this matter. The HSE public dental service provides care for children up to 16 years of age. It includes emergency care, a fissure sealant programme and care for orthodontics. There have, as the Deputy correctly said, been significant delays in the provision of these services. These were significant before Covid-19 arrived and, as with many other patient services, Covid has made them worse. It is not acceptable that children and their families are facing these long waiting periods for access to oral healthcare. It is a top priority for me and the Government to address it. Critically, we are backing that sentiment up with money, which is what matters. I have allocated an unprecedented €15 million in the budget for next year to enhance the provision of oral health services. A dedicated amount of nearly €5 million has been provided to develop a comprehensive oral healthcare package for children. This will make a huge difference. This is an intervention package for children from birth up to seven years of age and is aligned with the national oral health policy.
We will see the benefits of these packages in the years to come. On top of that, I have allocated €9 million specifically to address the waiting lists in orthodontics, which the Deputy has quite rightly called out, and to allow the public dental service to provide care to all eligible children. In addition to the €15 million allocation, resources will be available to recruit more orthodontists. There has been a specific request for orthodontists to provide clinical leadership within the HSE to drive this oral health strategy, Smile agus Sláinte. These staff will allow for the very substantial reform that is required right across the system.
I am curious about this because I was lucky enough to have been a beneficiary of it as a child. I got extensive dental treatment through the Eastern Health Board in my local health centre and then in St. James's Hospital right through until I was a little bit older than 16. I have seen the benefits it can have for those who need it, of whom there are many, when it works and is functioning. We have had this issue in a number of areas in health and beyond. We have money in the country and are providing it but where are we actually going to get these dentists? The Irish Dental Association has said we need 400 whole-time equivalent staff in our dental service to bring us to where we need to be. There is a role for the Minister, Deputy Harris, in resourcing third level and further education in UCD and Trinity College. What negotiations are taking place to ensure that we are able to develop dentists and orthodontists here but also to attract them from overseas?
While we need to keep going, what has been done this year? A number of community healthcare organisations, CHOs, have already run recruitment initiatives to fill the vacancies that exist. Vacancies equivalent to approximately 72 whole-time equivalent staff have been filled so far this year. That is very welcome progress. The HSE dental service recently held a recruitment event. It invited dentists who are registered or entitled to be registered with the Dental Council of Ireland. I am delighted to say that the event was well attended by dentists, who were expressing an interest in these jobs in the public service, which is where we need them. So far this year, there has been a net increase of 72. We are going to continue to push on that. We have sanctioned more roles because, as the Deputy quite rightly says, we need to build up the workforce. The Irish Dental Association is correct that we need significant additional numbers in the public service provision.
The public service provision is absolutely what we are talking about here and what we need to resource. Another thing being brought up by the dentists I am speaking to is the lack of oral or dental hygienists and how there may be a role for the national apprenticeship office in developing some kind of apprenticeship scheme in this area. The Irish Dental Association or dentists will probably call for that. We have a crisis and we need to work our way out of it.
We have spoken previously about the dental treatment services scheme, DTSS, and all of the challenges associated with it. We need to get dentists back into schools, examining children at a young age and getting them into streams to ensure they have good oral care and get any structural dental issues sorted out in their early teens, when it is most important. If there is any cosmetic dentistry needed on top of that, that should also be provided. These are real needs in our dental services that we are not providing for at the moment. We need to get back to where we were and to then improve from that point.
I thank the Deputy. I agree with all he has said. There are several layers to what we are doing. One is prevention. The programme we are now bringing in for children from birth up to seven years of age is really exciting. The second layer is building additional capacity in our public health service, which we have discussed, and the third is modernisation and reform. This is why we are introducing clinical leaders to the system, which we have not had before, to help with regard to models of care for children and adults. One area in which we need to be open to quite radical action is that of college places and training places. The reality is that we do not educate remotely enough healthcare professionals in our country. We need to see at least a doubling of college places. That would cover both groups of workers the Deputy has described, dentists and dental hygienists. We need to be radical and ambitious in scaling up the number of college places and training places in the coming years.
Questions Nos. 90 to 112, inclusive, taken with Written Answers.
Bogfaimid ar aghaidh go dtí an chéad cheist eile a bhfuil Teachta i láthair di, Uimh. 113. Tá sé cosúil leis an gcéad cheist a d'fhreagair an tAire, Uimh. 80.
Nursing Homes
Ruairí Ó Murchú
Question:113. Deputy Ruairí Ó Murchú asked the Minister for Health if he will provide an update on the timeline for an inquiry into nursing home care during the Covid-19 outbreak; and if he will make a statement on the matter. [51614/22]
We have already had a discussion. The Minister accepts that there needs to be a mechanism to provide necessary answers to families who lost loved ones. I am talking specifically about those who lost loved ones in Dealgan House nursing home. We need a timeline for when the work the Minister says his officials in the Department are doing will be complete. Will he give us the timeline and as much detail as possible on the type of mechanism being considered?
I ask that the Deputy bear with me for just one second. I apologise.
It is no problem. This question is similar to one asked earlier.
I thank the Deputy.
I am asking for a timeline for when the Minister will have the mechanism and, if he can go into any detail, the type of mechanism we are talking about.
The timelines will be worked through once we see the options. As we discussed earlier, families, some of whom I have met, have very reasonable and important questions. Essentially, they want to know what happened. In some cases, their loved ones died during the first Covid surge and they were faced with unimaginable difficulties in desperately trying to find out what was going on when not able to access the nursing home. All of the nursing homes came under enormous pressure but it was particularly bad in certain homes. Families want answers and access to the truth and they must have it. The Government and I want to find a process whereby those families can get those answers without the whole thing becoming legalistic and taking years with the risk that they may not ultimately get those answers. We have various options that we have seen work well in the past. For example, Dr. Scally's inquiry into CervicalCheck worked well. This was not a public inquiry. Dr. Scally took private testimony and produced what most of us agree was a very good and very useful report.
I know that there are people who are looking for a public inquiry but the problem with a public inquiry is that those involved, including those running the nursing homes, take legal advice, as they should. In the past, we have often seen legal teams go to the High Court to seek injunctions. We are then in a very difficult position because it becomes increasingly difficult to ask the questions that need to be asked and to get answers to them. This is further complicated by the fact that there are now quite a number of active court cases ongoing. As we all know, the legal advice that some of these nursing homes will get is that they should not participate. We need to find a mechanism that avoids all of that and gets the families the answers they deserve.
I accept that there are difficulties but it is fair to say that what the families want is a full public inquiry. The Minister has said that his officials are working on a mechanism that will provide them with answers. We need to see what that mechanism is going to be as soon as possible. We are already very late into the game. We are dealing with families who had to deal with a great deal of trauma in losing loved ones. There are specific circumstances with regard to Dealgan House and the fact that the HSE determined to take it over. The families require a number of answers but we also need to learn the necessary lessons for elder care in the future. We need to ensure that we do not create conditions such as these in the future because we do not know what conditions we may face. That is what we need as soon as possible.
The Deputy's final point is very important. Have we systematically looked at what did and did not work and made decisions to improve protections? The answer is that we have. The expert nursing home group was put in place and came back with some very comprehensive recommendations. There has been full support from the Government and a lot of investment through the budgets. Those recommendations have been rolled out at pace and have made, and continue to make, a big difference in providing the best possible protections for those living in long-term residential care.
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