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Tuesday, 26 Mar 2019

Written Answers Nos. 717-738

Nursing and Midwifery Board of Ireland

Questions (717, 718)

Clare Daly

Question:

717. Deputy Clare Daly asked the Minister for Health if his attention has been drawn to an email (details supplied); his views on the issues raised therein in regard to the corporate governance of the NMBI; and the steps he will take to address same. [13243/19]

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Clare Daly

Question:

718. Deputy Clare Daly asked the Minister for Health if his attention was drawn to an email by a person (details supplied); if so, the action undertaken by his Department following his attention being drawn to same. [13244/19]

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Written answers

I propose to take Questions Nos. 717 and 718 together.

I am informed that there is no record of the e-mail supplied by the Deputy being received by the Department. However, my Department is aware of the general nature of the issues raised in that e-mail. The e-mail relates to the handling by the Nursing and Midwifery Board of Ireland (NMBI) of an employment law matter which has been before State's industrial relations bodies.

Responsibility for ensuring that the NMBI complies with its obligations under the Code of Practice for the Governance for State Bodies, including issues relating to employment law, rests with the Board of the NMBI. I have no role in the day to day management of staffing issues in the NMBI.

Finally, as this matter referred to in the details supplied has been the subject of an industrial relations dispute, it is worth remembering that both the Labour Court and the Workplace Relations Commission are independent, statutory bodies. Given their statutory independence, I have no role when the bodies exercise their quasi-judicial functions in relation to industrial relations disputes or employment law complaints.

National Cervical Screening Programme Inquiry

Questions (719)

Micheál Martin

Question:

719. Deputy Micheál Martin asked the Minister for Health the number of applications received, granted and refused, respectively, for the ex gratia payments of €2,000 to the 221 women in particular to allow them to cover the cost of an independent review of their cervical smear slides which determines whether the readings fall into the limitations of screening or were negligently misread; and if he will make a statement on the matter. [13248/19]

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Written answers

Dr Gabriel Scally's first progress report, published in June 2018, recommended the immediate provision of a modest ex gratia payment to each woman involved and to the next of kin of the deceased. The purpose of this payment, as set out by Dr Scally, was to ensure that women did not encounter any financial obstacles to participating in the Scoping Inquiry and making their voices heard in this way.

Government accepted this recommendation, and I requested that the HSE make available a payment of €2,000 to each of the women, or next of kin of those women who have sadly died. To date, 214 applications for this payment have been received, and the HSE reports that all of these payments have been made.

The Deputy may wish to note that an Independent Clinical Expert Panel Review is being carried out by the Royal College of Obstetricians and Gynaecologists (RCOG), with expertise also sourced through the British Society for Colposcopy and Cervical Pathology. The purpose of the review is to provide women who participated in the national CervicalCheck screening programme and who developed invasive cervical cancer with independent clinical assurance about the timing of their diagnosis and treatment. Over 1,700 letters have been sent to women, and to the next-of-kin of women who have, sadly, died providing information in relation to consent and a consent form for participation in the review and, to date, 1,075 women have consented to be included in the review, or about 63% of those eligible. The review will provide an individual report to each woman, as well as an aggregated report for the Minister. Approximately half of the relevant slides have now transferred to the review laboratory and the cytology phase of the review is ongoing.

National Cervical Screening Programme Inquiry

Questions (720)

Micheál Martin

Question:

720. Deputy Micheál Martin asked the Minister for Health when he will publish the details of the alternative scheme recommended by a person (details supplied) on dealing with claims from CervicalCheck; and if he will make a statement on the matter. [13249/19]

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Written answers

Mr Justice Meenan's report on an alternative system for dealing with cases arising from CervicalCheck was published on 16 October 2018. Following consultation with relevant Departments, the Government agreed on 18 December to my proposal to establish an independent statutory tribunal, chaired by Ms Justice Mary Irvine, to deal with claims arising from CervicalCheck. The Tribunal will be established based on the recommendations set out by Mr Justice Meenan.

The establishment of the Tribunal is an urgent priority for the Government and my Department is currently preparing the necessary legislative proposals to expedite this. I will be submitting the draft heads and general scheme of a Bill to Government shortly.

National Cervical Screening Programme Administration

Questions (721)

Micheál Martin

Question:

721. Deputy Micheál Martin asked the Minister for Health if the CervicalCheck steering committee will be in situ until the Scally report recommendations are fully implemented; if the terms of reference need to be updated to allow for an extension and to ensure that the backlog has been cleared, RCOG review is complete and the HPV screening programme has begun to be rolled out; and if he will make a statement on the matter. [13250/19]

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Written answers

In June 2018, I established the CervicalCheck Steering Committee to provide oversight and assurance on the implementation of key decisions taken by Government in relation to CervicalCheck, and to work to ensure a sustainable and effective cervical screening programme in the interests of women’s health. The Committee is chaired by my Department and membership includes senior officials from my Department and the HSE, clinicians and patient advocates and representatives. The Terms of Reference for the Committee are published on my Department’s website, as are the agenda and minutes of all Committee meetings.

Since its inception, the Committee has met 17 times and has overseen significant progress in a number of key areas. There is now a well-established and stable process for the provision of supports to women and families, in accordance with the Government decision; key staff have been appointed to CervicalCheck including a Clinical Director and staff with public health and cytopathology expertise; approximately 1,075 women have consented to be included in the Independent Clinical Expert Review and the slides are currently being independently reviewed. The Review will provide much needed-clarity for the women involved, and I look forward to receiving and publishing the Royal College's report. 

In September, the Scoping Inquiry led by Dr Gabriel Scally completed its Report, providing a clear picture of what happened, and improving the understanding of the screening and audit processes and their limitations. The Committee oversaw the development of an Implementation Plan for all 50 recommendations of the Scoping Inquiry. The Implementation Plan published in December provides the necessary foundation to ensure a highly effective and well managed cervical screening programme. I welcome Dr Scally's recent progress report, published on the website of my Department last Thursday, in which he affirms that the Implementation Plan is a comprehensive response to his report, that significant effort and resources are being committed to addressing the problems he identified, and that the appropriate resourcing and project management structures are in place. The continued implementation of Dr Scally's recommendations is a key priority.

A second key priority is the introduction of the HPV test as the primary screening test. In conjunction with the extension of the HPV vaccine to boys, this will represent a significant step forward in public health and it presents the opportunity to work towards the near-eradication of cervical cancer. A project team is in place in the HSE and work is ongoing to drive this complex project forward.

In tandem with this, a third key priority is to address smear testing capacity challenges such that the current backlog is eliminated and we ensure a sustainable programme into the future. The HSE is working very actively to put in place additional capacity, following extensive searches internationally.

My Department and the HSE have been working intensively and at the highest levels to ensure these identified priorities are progressed as swiftly as possible, and continue to do so, and they are also the subject of discussion and reporting at monthly meetings of the Steering Committee. I am satisfied that the terms of reference of the Steering Committee encompass all of these matters but of course these are kept under review. I understand that the Committee is currently giving consideration to how best to support progress on these priorities and I look forward to this important work continuing.

Hospital Internships

Questions (722)

Stephen Donnelly

Question:

722. Deputy Stephen Donnelly asked the Minister for Health if medical students who graduated in Latvia are ineligible for internships in hospitals here as they are deemed to have completed their basic medical training; and if he will make a statement on the matter. [13282/19]

View answer

Written answers

I have asked the HSE to respond directly to the Deputy on this matter.

Disease Management

Questions (723)

Fergus O'Dowd

Question:

723. Deputy Fergus O'Dowd asked the Minister for Health the services available to persons suffering from Lyme disease; his plans to expand available treatment and specialist care for the disease; the number of specialist consultants available through the public system; the average length of time a person waits for assessment and treatment; and if he will make a statement on the matter. [13286/19]

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Written answers

As this PQ refers to a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.

Healthcare Infrastructure Provision

Questions (724)

Louise O'Reilly

Question:

724. Deputy Louise O'Reilly asked the Minister for Health the time frame for planning and construction of the new primary healthcare centre at Buncrana, County Donegal. [13293/19]

View answer

Written answers

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

Hospitals Building Programme

Questions (725)

Louise O'Reilly

Question:

725. Deputy Louise O'Reilly asked the Minister for Health when the HSE and his Department will release the funding for Letterkenny University Hospital to extend the renal dialysis unit to incorporate space already within the hospital campus. [13294/19]

View answer

Written answers

In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.

Hospital Overcrowding

Questions (726)

Louise O'Reilly

Question:

726. Deputy Louise O'Reilly asked the Minister for Health the reason the HSE did not provide funding to reopen all 20 beds at the short-stay ward of Letterkenny University Hospital as applied for by the management of the hospital. [13295/19]

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Written answers

As Minister for Health, I recognise that hospitals are increasingly operating at or above capacity, with year-round demand pressures that are further challenged over the winter months.

It is against this background that the Health Service Capacity Review 2018 recommended an increase in acute hospital beds of over 2,600 by 2031 to support the projected increase in demand for services in the years ahead. The National Development Plan provides for the full 2,600 beds over its lifetime.

Over the past 18 months, an additional 241 beds have been opened nationally.

The HSE Winter Plan includes the opening of an additional 75 beds in early 2019, including 5 acute inpatient beds in Letterkenny University Hospital. The plan also seeks to ensure that the health system is as prepared as possible for the increase in demand on services over the winter months, within existing capacity and financial parameters.

Further to that, the National Service Plan 2019 provides for the preparation of 202 additional beds, to be operational in Q1 2020, including 15 inpatient beds in Letterkenny University Hospital.

In relation to the Deputy's query, as this is a service matter, I have asked the HSE to reply to the Deputy directly. `

Brexit Preparations

Questions (727)

Louise O'Reilly

Question:

727. Deputy Louise O'Reilly asked the Minister for Health if funding has been earmarked and set aside to prepare the health service for Brexit; and if he will make a statement on the matter. [13296/19]

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Written answers

The Department of Health is, in line with Government priorities, continuing to prepare for a no deal Brexit, in the overall context of the Government's objective to secure an orderly withdrawal of the UK from the EU.

Approximately €10m has been identified to date by the Department and its agencies in the context of no deal Brexit contingency planning. These additional costs mainly relate to additional staff for the HSE Environmental Health Service and the HPRA, and also includes additional funding for the HSE’s Public Analyst Laboratory Dublin (PALD) and additional facilities at Dublin Port to cater for an increased number of food safety inspections to ensure compliance with EU regulations and to protect public health through proper Sanitary and Phytosanitary (SPS) checks and controls.

Further costs may arise in the health sector as a result of Brexit - this will be kept under review.

Childhood Obesity

Questions (728)

Louise O'Reilly

Question:

728. Deputy Louise O'Reilly asked the Minister for Health his plans to turn the recommendations of the report on tackling childhood obesity into legislation and, specifically, that no fast food outlet be built within 1 km of a school. [13297/19]

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Written answers

The recommendation referred to by the Deputy was aligned by the Obesity Policy Implementation Oversight Group with Step 2 of the Obesity Policy Action Plan Regulate for a healthier environment. One of the Actions under this Step is to "Develop guidelines and support material for those working in developing the built environment for urban development and planning in relation to reducing the obesogenic environment". The OPAP recognised that changing the obesogenic environment is a critical factor underpinning the success of maintaining the population at a healthy weight. The prevention approach aims to gradually change Ireland's food environment to one that facilitates consumption of healthier food and drinks and fosters active lifestyles. The OPAP acknowledged that food and retail outlets are more widely available now than ever before and that this becomes important as children have discretionary income and may not follow the healthy eating guidelines. It therefore declared that it is important that the health input into the local area planning process is consistent and evidence based.

This area is being progressed through engagement with other Government Departments to support the work of stakeholders involved in planning and developing the built environment.

In line with Actions 31 of the NPAP and 2.1 of the OPAP, which commit to developing guidelines and support materials for those working in developing the built environment in order to promote the importance of physical activity, and Action 59 of the NPAP which commits to developing a programme of on-going stakeholder communication and engagement, a Stakeholder Forum was held on 21 November last.

The event was planned in partnership, with substantial input from three Government Departments, (Health; Transport, Tourism and Sport; and Housing, Planning and Local Government). Following on from this Forum, a working group made up of representatives of all three departments was convened to consider the outputs of the stakeholder forum and related recommendations, including the ones aligned with the recommendation referred to by the Deputy.

Finally, the question of legislation around planning matters for the issue raised by the Deputy is ultimately a matter for my colleague the Minister for Housing, Planning and Local Government, and I understand that he has addressed the position on this in his reply to Parliamentary Question 34831/17. For convenience a link to this question is here: https://www.oireachtas.ie/en/debates/question/2017-07-13/1332/?highlight%5B0%5D=34831

Hospitals Capital Programme

Questions (729)

Alan Kelly

Question:

729. Deputy Alan Kelly asked the Minister for Health the projects that will be affected by the €24 million cut to the health capital budget; if the cut will result in further delay to persons with disabilities who are due to move from institutions to homes in the community; and if he will make a statement on the matter. [13305/19]

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Written answers

The Government recently outlined how the €99m necessary this year for the timely provision of the new children’s hospital will be accommodated with a minimum of disruption to the scheduled rollout of key infrastructure projects under Project Ireland 2040.

The new children’s hospital is a vital and much needed project and the Government has examined the funding pressures associated with delivering this important project.

In meeting these funding pressures, Government has examined all projects and programmes across Government and has made adjustments to ensure that the much-needed new children’s hospital will be delivered and will facilitate delivering the overall investment programme, as set out in Project Ireland 2040.

Projects that are currently in construction and are contractually committed will not be affected.

The Government decided €24m of this is to be provided from the health capital allocation.

The Health Service Executive is currently developing its Capital Plan for 2019. The HSE Capital Plan will determine the projects that can progress in 2019 and beyond having regard to the available capital funding, the number of large national capital projects currently underway and the relevant priority of each project.

The requirements of the new children's hospital and other health capital projects including capital proposals for Disability Services, currently at various stages of development, are being considered as part of this process. Once the HSE has finalised its Capital Plan for 2019, it will then be submitted to me for consideration.

HSE Properties

Questions (730)

Jackie Cahill

Question:

730. Deputy Jackie Cahill asked the Minister for Health if he will request the HSE to engage with a committee (details supplied) in County Tipperary; and if he will make a statement on the matter. [13306/19]

View answer

Written answers

As the Health Service Executive is responsible for the management of the healthcare property estate, I have asked the HSE to respond directly to you in relation to this matter.

Nursing Staff Recruitment

Questions (731)

Louise O'Reilly

Question:

731. Deputy Louise O'Reilly asked the Minister for Health his plans to replace the vacant nursing post at a centre (details supplied) in County Westmeath, which was vacated over two months ago; and if filling the post will be prioritised. [13309/19]

View answer

Written answers

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

Nursing Staff Recruitment

Questions (732)

Louise O'Reilly

Question:

732. Deputy Louise O'Reilly asked the Minister for Health the reason for the delay in replacing the nursing post at a centre (details supplied) in County Westmeath that has been left vacant for two months; and his plans to deal with the mounting administrative backlog that is impacting on the delivery of essential services. [13310/19]

View answer

Written answers

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

Child and Adolescent Mental Health Services Staff

Questions (733)

Louise O'Reilly

Question:

733. Deputy Louise O'Reilly asked the Minister for Health whether the psychiatrist tasked with covering child referrals from a centre (details supplied) in County Westmeath responsible for covering the county is unable to accept new referrals due to the delay in filling the nursing point at the centre, which has remained vacant for the past two months; and if he will make a statement on the matter. [13311/19]

View answer

Written answers

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

Dental Services Waiting Lists

Questions (734)

Niamh Smyth

Question:

734. Deputy Niamh Smyth asked the Minister for Health the reason a person (details supplied) has been waiting a lengthy period for a dental appointment; and if he will make a statement on the matter. [13312/19]

View answer

Written answers

As this is a service matter it has been referred to the HSE for reply to the Deputy.

Hospital Appointments Status

Questions (735)

Pearse Doherty

Question:

735. Deputy Pearse Doherty asked the Minister for Health when a person (details supplied) will receive an appointment for a hip operation in Letterkenny University Hospital; and if he will make a statement on the matter. [13314/19]

View answer

Written answers

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.

The National Waiting List Management Policy, a standardised approach to managing scheduled care treatment for in-patient, day case and planned procedures, since January 2014, has been developed to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care. This policy, which has been adopted by the HSE, sets out the processes that hospitals are to implement to manage waiting lists.

In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.

Vaccination Programme

Questions (736)

Michael Fitzmaurice

Question:

736. Deputy Michael Fitzmaurice asked the Minister for Health his plans to offer a free vaccine against the meningococcal B virus for children born prior to 1 October 2016; and if he will make a statement on the matter. [13315/19]

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Written answers

The National Immunisation Advisory Committee (NIAC) is an independent committee of the Royal College of Physicians of Ireland which is comprised of experts from several specialties, including infectious diseases, paediatrics, and public health, which makes recommendations to my Department on vaccination policy in Ireland. Its 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.

On foot of a recommendation by NIAC, the Primary Childhood Immunisation Schedule was amended in 2016 to include the introduction of the Meningitis B vaccine for all babies born on or after 1 October 2016. This change to the immunisation schedule took effect from 1 December 2016. The first dose of the vaccine is administered to children when they reach two months of age; a second dose is administered at four months and a third and final dose at twelve months. Meningitis B disease is most common in babies under the age of 1 year old and the scheduling of the administration of the vaccine under the immunisation programme takes account of this.

All vaccines administered through the Primary Childhood Immunisation Schedule are provided free of charge. Ireland is the second country in Europe to make the Men B vaccine available free of charge as part of its national immunisation programme.

There are no plans to introduce a catch-up programme for the Men B vaccine to older children. Those who have a medical card are eligible to have the vaccine administered by their GP free of charge. However, the purchase of the vaccine is not covered by the medical card scheme.

In Ireland, Men B; Men C; PCV and Hib vaccines are offered to children to protect them against meningitis. Adolescents are also given a Men C booster vaccine in the first year of secondary school against meningitis as part of the School Immunisation Programme.

Healthcare Professionals

Questions (737)

Pat Buckley

Question:

737. Deputy Pat Buckley asked the Minister for Health if his attention has been drawn to the fact the SouthDoc in Youghal, County Cork is not in use; the rationale for same; his plans to rectify the issue; and if he will make a statement on the matter. [13316/19]

View answer

Written answers

As this question relates to a service matter I have arranged for it to be referred to the HSE for direct reply to the Deputy.

Nursing Homes Support Scheme Review

Questions (738)

Pat Deering

Question:

738. Deputy Pat Deering asked the Minister for Health when the report reviewing the system for setting nursing homes prices under the nursing home support scheme will be published; and if he will make a statement on the matter. [13326/19]

View answer

Written answers

The Nursing Homes Support Scheme (NHSS), commonly referred to as Fair Deal, is a system of financial support for people who require long-term residential care. Participants contribute to the cost of their care according to their means while the State pays the balance of the cost. The Scheme aims to ensure that long-term nursing home care is accessible and affordable for everyone and that people are cared for in the most appropriate settings.

The Report of the NHSS Review published in 2015 identified a number of issues for more detailed consideration, including a review of the pricing mechanism used by the NTPF, with a view to:

- Ensuring value for money and economy, with the lowest possible administrative costs for clients and the State and administrative burden for providers;

- Increasing the transparency of the pricing mechanism so that existing and potential investors can make as informed decisions as possible; and

- Ensuring that there is adequate residential capacity for those residents with more complex needs.

A Steering Group was established to oversee and manage the pricing review. The Steering Group is chaired by the NTPF and includes representatives from the Department of Health and the Department of Public Expenditure and Reform (DPER). As part of its work on the review the NTPF sought various inputs including external expertise and stakeholder engagement to inform the review. These inputs are being considered in detail.

I understand that the NTPF is now close to completing the report and it is expected that the Steering Group will be provided with a final draft very shortly. Once complete the report of the review will then be submitted to the Department of Health.

It is recognised that any change to any part of the Scheme must be considered in terms of the short- and long-term impact on the viability of the Scheme and accessibility of long-term residential care in general. It is therefore important that the relevant issues are considered thoroughly through the review process.

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