Written Answers Nos. 623-642
623. Deputy Mattie McGrath asked the Minister for Health if it will be made mandatory for clinics and services providing non-invasive prenatal tests to ensure that websites belonging to such clinics and services properly inform persons of the positive predictive values of the tests they offer (details supplied); and if he will make a statement on the matter. [2972/20]
View answerAs this is a service issue, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
624. Deputy Mattie McGrath asked the Minister for Health the number of staff recruited and the number of staff who have signed contracts for work at the modular unit located at South Tipperary General Hospital; and if he will make a statement on the matter. [2973/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to you directly as soon as possible.
625. Deputy Mattie McGrath asked the Minister for Health the measures he is taking to address the safety and capacity issues within the maternity hospital network in view of recent HIQA reports that identified serious failings in maternity care and significant service deficits; and if he will make a statement on the matter. [2974/20]
View answerThe Health Information and Quality Authority’s National Standards for Safer Better Maternity Services were published in 2016. These Standards were developed to support the implementation of the National Maternity Strategy in its aim to provide woman-centred, integrated, high quality team-based care to women and to ensure that maternity services meet the needs of the women and newborns by delivering safer, better and standardised services.
HIQA has recently published reports of its monitoring programme against the National Standards at each maternity unit/hospital, along with an overview report into maternity services nationally. While the findings of these reports are largely positive, identifying high levels of compliance against most of the Standards assessed, the reports identify areas where further work is required.
My Department is engaging with the HSE in order to ensure that a plan is developed to implement the recommendations. This will inform necessary service improvements and ensure that the positive findings are not only enhanced but sustained into the future.
626. Deputy Mattie McGrath asked the Minister for Health the number and date of the meetings he has had with organisations (details supplied) with respect to the delivery of termination-of-pregnancy services from 2018 to date; and if he will make a statement on the matter. [2975/20]
View answerI met with the organisations the Deputy refers to on the 2nd of October 2018, the 12th of November 2018, 10th of December 2018 and the 24th of May 2019 to discuss termination of pregnancy services.
As you will be aware, the Health (Regulation of Termination of Pregnancy) Act was passed in the Houses of the Oireachtas on 13th of December 2018 and signed into law by the President on 20th of December 2018. The service for termination of pregnancy commenced on 1 January 2019.
627. Deputy Mattie McGrath asked the Minister for Health the status of the implementation of Sláintecare; and if he will make a statement on the matter. [2976/20]
View answerThe Sláintecare Action Plan sets out detailed timeframes for 239 deliverables to be progressed in 2019 as the first year in the implementation of the Sláintecare vision, and firmly establishes a programmatic approach to the delivery of the Sláintecare strategy. There were 114 deliverables for the period up to September 2019, of which over 90% were on track.
The final 2019 progress report is expected to be published shortly.
Key achievements in implementation include:
- Government agreement to establish six new regional health areas that will align and integrate Hospital Groups and Community Healthcare Organisations, which is a first major step towards restructuring our health services in line with recommendations in the Oireachtas Committee report;
- supporting the findings of the Independent Review Group established to examine private activity in public hospitals (the De Buitléir Report) with the decision and announcement that all future consultant appointments, from second quarter 2020, will be to the new Sláintecare Consultant contract for public only work;
- Revised GP contractual arrangements, which will see a € 210 million investment (40% increase) in General Practice over the next four years of which €80 million will be available for the management of chronic diseases, like diabetes and COPD, through family doctors. This is expected to benefit more than 400,000 patients;
- strengthening the Health Service Executive with the formal appointment of the HSE Board in May 2019 and the appointment of a new HSE Chief Executive Officer (CEO).
- €20 million for 122 Integration Fund projects, designed to promote the engagement and empowerment of citizens in the care of their own health, scale and share examples of best practice and processes for chronic disease management and care of older people and encourage innovations in the shift of care to the community or provide hospital avoidance measures.
Other milestones in implementation include:
- Nine Community Healthcare Network (CHN) learning sites, designed to deliver Primary Health Care Services across an average population of 50,000, have been identified and Network Managers appointed. Implementation lessons from the learning sites will inform further rollout of the wider CHN model across the country.
- An Elective Hospital Oversight Group has been established to established to guide the development of policy on dedicated elective/ambulatory hospitals.
- Budget 2020 provided a €10m Enhanced Community Care Fund, rising to €60m in 2021, funding up to 1,000 therapists, nurses and other frontline staff to care for people in the community, including advisers for people with dementia. This will allow us to treat people in the community, closer to their own homes, reducing community waiting lists.
- A care redesign fund of €12m has been provided to develop integrated care and enable people to access the right care in the right place at the right time.
- The Independent Patient Advocacy Service was established.
- Government approval was received to initiate the tender process for the Electronic Health Record in the National Children’s Hospital.
- The National Patient Experience Survey has now expanded to maternity services.
- The Smile agus Sláinte National Oral Health Policy was published in April 2019 with a commitment to elements of universal healthcare to be implemented between 2020 to 2026.
- The Healthy Ireland Outcomes Framework was published, and the Healthy Ireland Survey 2019 has been published.
Priorities for 2020
Building on the foundations and achievements of 2019, Sláintecare will progress three multi-annual, jointly implemented priority reform programmes for 2020, which are to:
- develop and implement the business case for the Regional Health Areas to enable integrated patient-centred services, that are safe, local and fairly distributed;
- develop and implement a Capacity and Access programme to address the findings of the Health Service Capacity Review and reduce waiting times;
- examine eligibility and entitlement to health and social care services to make sure cost is not a barrier to getting care in a timely manner.
628. Deputy Mattie McGrath asked the Minister for Health the status of the measures he is taking to address the lack of access to general practitioner services in rural locations; and if he will make a statement on the matter. [2977/20]
View answerThe Government is aware of the workforce issues facing general practice, including those affecting rural areas, and has implemented a range of measures in recent years to improve recruitment and retention in general practice. Enhanced supports for rural GP practices have been introduced, and have been increased under the 2019 Agreement between the Department of Health, the HSE, and the IMO.
Other measures include changes to the entry provisions to the GMS scheme to accommodate more flexible/shared GMS GP contracts, and to the retirement provisions for GPs under the GMS scheme, allowing GPs to hold GMS contracts until their 72nd birthday.
In addition, the number of medical graduates undertaking GP training has increased from 120 in 2009 to 192 filled places in 2019. 217 training places are available for 2020, and the number of doctors applying to the training scheme commencing in 2020 is the highest on record at 461.
The Agreement reached in 2019 on GP contractual reforms and service developments will see an increase in expenditure on GP services of €210 million annually by 2023, providing significant increases in capitation fees for participating GPs, and increases in supports for rural practices and practices in urban areas of deprivation.
Improved family friendly arrangements are another important feature of the revised contractual arrangements, with an increase in the locum rate for maternity and paternity cover, and an increase in the paternity leave allowance from 3 days to 2 weeks. This is in recognition of the need to ensure that general practice is compatible with doctors’ family commitments.
I am confident that these measures will help make general practice more sustainable and a more attractive career option for doctors.
629. Deputy Mattie McGrath asked the Minister for Health if his Department is notified of the number of general practitioner practices that are not in a position to accept new patients to their patient list; if so, if the information will be provided; and if he will make a statement on the matter. [2978/20]
View answerGPs are independent practitioners who hold contracts with the HSE for the provision of services to medical card and GP visit card holders. The HSE does not collect data in relation to the number of GP’s who are not in a position to accept new GMS or private patients onto their patient lists.
The GMS GP contract stipulates that the maximum number of medical card or GP visit card patients that a GP can have on his/her panel is 2,000, or 2,200 if the GP also holds an under 6 contract, except for in exceptional circumstances where the HSE decides to apply a higher limit. As of 1st of March 2020, only 6 of the 2,486 GMS contract holders in the country have reached or exceeded the 2,200 maximum patient limit and the average panel size for GPs was 832 GMS patients.
Where a GMS patient experiences difficulty in finding a GP to accept him/her as a patient, the HSE has the power to assign that person to a GP's GMS patient list where the person has unsuccessfully applied to at least three GPs in the area who hold GMS contracts.
People who do not hold a medical card or GP visit card access GP services on a private basis and can make enquiries directly to any GP practice they wish to register with.
As private contractors, it is a matter for each individual GP to decide whether to accept additional private patients. In some instances, GP practices have a full list of patients and cannot take on new patients. If this happens, patients should contact other GP practices in their area. While I have no role in relation to such matters, I would expect clinicians to consider the importance of patients having access to a GP service close to home when deciding whether or not to accept private patients.
630. Deputy Mattie McGrath asked the Minister for Health the latest measures being adopted to tackle the spread of Covid-19 and to increase preparedness here; and if he will make a statement on the matter. [2982/20]
View answerIreland has advanced plans in place as part of its comprehensive preparedness to deal with public health emergencies such as the one we are now experiencing in relation to Covid-19 (Coronavirus). These plans have developed from Ireland’s response to similar incidents such as pandemic influenza, SARS and MERS in the past.
Prior to the declaration by the World Health Organization on 30 January 2020 that the outbreak of Coronavirus originating in Wuhan, China, meets the criteria for a Public Health Emergency of International Concern (PHEIC) in accordance with the provisions of the International Health Regulations (2005), Ireland has been monitoring the situation since it originally arose in December, 2019. We have been preparing for the potential consequences since then.
To the greatest extent possible, in matters relating to emerging international public health incidents, Ireland follows the advice and guidance of the World Health Organization (WHO) and the European Centre for Disease Prevention and Control (ECDC) and continues to do so as the situation evolves.
The National Public Health Emergency Team (NPHET) is the forum for managing the interface between the Department of Health and the Health Service Executive during the planning and response phases of a public health emergency. The NPHET is chaired by the Chief Medical Officer and held its first meeting in relation to Covid-19 on Monday 27 January and has continued to meet regularly since then.
In addition, an Expert Advisory Group provides scientific advice and assistance to the NPHET in carrying out its work.
We are very conscious of the impacts on other sectors outside of health. Issues such as port health, travel advice, contingency planning, communications as well as advice and guidance to various sectors, including the public, are being kept under constant review.
The Government has also agreed to establish a Cabinet Committee (chaired by the Taoiseach), to assess the social and economic impacts of the potential spread of COVID-19. The work of the Cabinet Committee will include advice on downstream impacts, mitigations and contingencies for cross-sectoral issues and builds on the effective public health work undertaken to date. The cross-government approach to the coronavirus response will be based around cohesive decision-making, partnership, expert public health advice and clarity of communications.
The Minister for Health signed the Infectious Diseases (Amendment) Regulations 2020 (S.I. No. 53 of 2020) on Thursday 20th February 2020. These Regulations made provision for Covid-19 to be added to the list of notifiable diseases so that doctors will be obliged to notify the HSE when a case is suspected or diagnosed.
The HSE’s Health Protection Surveillance Centre (HPSC) is closely monitoring the emerging situation and is collaborating with the Department, other Departments and various agencies in relation to preparedness measures.
We have six cases in Ireland and three in Northern Ireland. The six cases in Ireland include two in the East and four in the West. All cases were identified and tested in line with established protocols for the investigation of suspect cases of Covid-19 and all are associated with travel from an affected area in Northern Italy, rather than contact with another confirmed case. The HSE is working to identify contacts the patients may have had, to provide them with information and advice to prevent further spread. None of the patients have been named publicly by the Department of Health or the HSE in order to protect patient confidentiality. We have also been working closely with the public health authorities in Northern Ireland and public health authorities have activated all appropriate contact tracing protocols.
The National Public Health Emergency Team, at its meeting on 3 March 2020, has recommended the following:
- Ireland’s case definition remains the same. It will continue to be reviewed by the National Public Health Emergency Team as the global situation evolves;
- On public health grounds, the travel advice for Italy is updated to advise against all non-essential travel to the following four regions: Lombardy, Veneto, Emilia-Romagna and Piedmont;
- Mass Gatherings Guidelines to be published in the coming days, following cross Government review;
- The HSE now moves to a community testing model for assessment and investigation of suspect cases;
- Four sub-groups have been established to review arrangements for vulnerable people, Health & Social Care Workers Protection, Acute Hospital Preparedness, Continuity of supply of Medicines and Medical Devices.
Ireland remains in containment phase, where the focus is on identifying and isolating any possible cases and ensuring rigorous infection prevention and control and contact tracing procedures are in place.
Due to circumstances constantly evolving the Chief Medical Officer and NPHET will continue to communicate key public health messages to the public to keep them informed and up to date in relation to all matters concerning Covid-19. All relevant information will continue to be published on the websites of the HSE, the HPSC and Gov.ie.
631. Deputy Pádraig Mac Lochlainn asked the Minister for Health the approach of his Department and the HSE to requests for persons suffering with Lyme disease or chronic Lyme disease to be properly supported by the health authorities here; and the reason there is no joint approach between health authorities and local authorities that have erected signage warning of the dangers of ticks. [2989/20]
View answerThe HSE Health Protection Surveillance Centre (HPSC) is responsible for the surveillance of notifiable infectious diseases such as Lyme disease. The Scientific Advisory Committee of the HPSC established a Lyme Borreliosis Subcommittee to look at ways of increasing public awareness. Part of the work of the Subcommittee is to ensure that all GPs are familiar with identifying and managing Lyme disease. The HPSC website (hpsc.ie) provides extensive information on Lyme disease diagnosis, treatment and how to avoid tick bites for the general public and health professionals.
As this PQ refers to operational matters regarding Lyme disease, I have referred it to the Health Service Executive for attention and direct reply to the Deputy.
632. Deputy Michael Healy-Rae asked the Minister for Health if the case of a person (details supplied) will be addressed; and if he will make a statement on the matter. [2990/20]
View answerMaintaining scheduled care access for all patients is a key priority for hospitals. I fully acknowledge the distress and inconvenience for patients and their families when elective procedures are cancelled, particularly for clinically urgent procedures.
The HSE advise that they are very cognisant of the impact that a change in admission for surgery has on patients, and as such every effort is made to avoid cancellation or postponement of planned procedures and operations. The HSE further advise that patients are scheduled based on clinical need, but that unfortunately surgery may be deferred due to consultants needing to prioritise emergency cases. The decision to delay admission is not undertaken lightly and when such a decision is made, it is based on the safe delivery of care to all patients.
In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.
633. Deputy Denis Naughten asked the Minister for Health when an assessment (details supplied) will be completed; the status of same; and if he will make a statement on the matter. [2994/20]
View answerThe HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drug schemes, in accordance with the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013; therefore, the matter has been referred to the HSE for reply to the Deputy.
634. Deputy Pádraig Mac Lochlainn asked the Minister for Health if the autism therapist post has been filled to support families in the Inishowen area of County Donegal (details supplied). [2996/20]
View answerAs the Deputy's question relates to a service issue it has been referred to the HSE for direct reply.
635. Deputy Mary Butler asked the Minister for Health when a person (details supplied) will receive an appointment for speech and language therapy supports; and if he will make a statement on the matter. [2998/20]
View answerAs this question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply.
636. Deputy Pádraig O'Sullivan asked the Minister for Health if he will consider reimbursing the cost of respite care to a person (details supplied). [2999/20]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
637. Deputy Niamh Smyth asked the Minister for Health the reason the dental centre at Darley healthcare centre, Cootehill, County Cavan, has been closed for the past six weeks; and if he will make a statement on the matter. [3009/20]
View answerAs this is a service matter it has been referred to the HSE for direct reply to the Deputy.
638. Deputy Charlie McConalogue asked the Minister for Health when a replacement scheme will be announced for the mobility allowance and motorised transport grant; and if he will make a statement on the matter. [3011/20]
View answerTwo schemes, the Mobility Allowance and Motorised Transport Grant, were put in place in 1979 and 1968 respectively, for operation by the Health Service Executive (HSE) at a time when there was limited availability of accessible public transport.
The Government decided to close these administrative schemes in 2013, on foot of the reports of the Ombudsman in 2011 and 2012 regarding the legal status of both Schemes in the context of the Equal Status Acts. The HSE has continued to pay an equivalent monthly payment on an interim basis, to those who were in receipt of the Mobility Allowance at the time that the Scheme closed.
Of the 4,700 individuals in receipt of the Mobility Allowance (€9 million per annum) when the Scheme closed in 2013, there were 3,831 people in receipt of the interim payments at July 2019. Of these recipients, 2,030 are in receipt of the full allowance rate of €208.50 per month.
There are improvements in access to a range of transport supports available to persons with disabilities in the State, for example the Disabled Drivers and Disabled Passengers scheme, operated by the Revenue Commissioners; the Free Travel Scheme operated by the Department of Employment Affairs and Social Protection; and CLÁR funding, approved by the Minister for Rural and Community Development, to voluntary organisations providing transport for people with significant mobility issues.
Under the National Disability Inclusion Strategy 2017 - 2021, the Department of Transport, Tourism and Sport has responsibility for the continued development of accessibility and availability of accessible public transport.
While consideration of the issues regarding the provision of transport supports for people with a disability continues within the Department of Health, recent developments which will impact on policy options include the following:
- The ongoing progress by the Department of Transport, Tourism and Sport in providing accessible public transport nationally and that Department's public consultation launched on 14 November last, to review active travel and public transport policy, including accessible public transport; and
- The Cost of Disability Study currently underway which was commissioned by the Department of Employment Affairs and Social Protection as part of Budget 2019. The research, when complete, will inform policy direction in relation to the provision of adequate supports to meet the needs of people with disabilities, including transport costs, from a whole of Government perspective.
639. Deputy Aindrias Moynihan asked the Minister for Health if the draft legislation for the proposed changes to the fair deal scheme has been prepared and is ready to be introduced to Dáil Éireann; and if he will make a statement on the matter. [3020/20]
View answerThe proposed policy change to the Nursing Homes Support Scheme (NHSS), to cap contributions based on farm and business assets at 3 years where a family successor commits to working the productive asset, has been approved by Government. The Department developed draft Heads of Bill while considering a number of complex ancillary policy and operational matters which may need to be addressed in the proposed legislation.
The General Scheme of Bill for the Amendment to the NHSS was approved by Government on 11 June 2019 and subsequently published. The changes to the Scheme will come into effect as soon as the legislative process is successfully complete. The General Scheme was sent to the relevant Joint Committee and the Department participated in pre-legislative scrutiny on 13 November 2019. Engagement with the Office of the Attorney General continues with a view to progressing the legislative development process.
It is intended that this proposed policy change, the 3 year cap, will be extended to eligible existing participants in long term residential care so that they are not disadvantaged, but that there would be no retrospective recoupment of contributions for those who have paid contributions over and above the 3 year period.
640. Deputy Aindrias Moynihan asked the Minister for Health the status of the reconfiguration of services for children with autism in County Cork; and if he will make a statement on the matter. [3021/20]
View answerAs the Deputy's question relates to a service issue it has been referred to the HSE for direct reply.
641. Deputy Bernard J. Durkan asked the Minister for Health when a second procedure will take place in the case of a person (details supplied); and if he will make a statement on the matter. [3052/20]
View answerUnder 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.
I have asked the HSE to examine the particulars of this case, and to respond to the Deputy directly.
642. Deputy Mary Butler asked the Minister for Health his plans to include the costs of blood tests for holders of medical cards under the provisions and benefits of the medical card scheme; and if he will make a statement on the matter. [3060/20]
View answerThe provision of routine phlebotomy services (blood tests) without charge to persons who hold a medical card or GP visit card is already included under the current GMS contract. However, I am aware that some GPs are charging GMS patients for phlebotomy services in some circumstances.
Under the terms of the GMS contract, GPs are required to provide eligible patients with ''all proper and necessary treatment of a kind usually undertaken by a general practitioner and not requiring special skill or experience of a degree or kind which general practitioners cannot reasonably be expected to possess." There is no provision under the GMS GP contract for medical card or GP visit card holders to be charged for routine phlebotomy services provided by their GP which are required to either assist in the diagnosis of illness or the treatment of a condition.
The HSE has advised GPs that where a blood test forms part of the investigation or necessary treatment of a patient’s symptoms or conditions, this should be free of charge for patients who hold a medical card or GP visit card.
If a patient who holds a medical card or GP visit card believes he or she has been incorrectly charged for routine phlebotomy services by his or her GP, then that patient should report the matter to their HSE Local Health Office.
