Michael Healy-Rae
Question:325. Deputy Michael Healy-Rae asked the Minister for Health the status of an appointment for a person (details supplied); and if he will make a statement on the matter. [9727/20]
View answerHospital Appointments Status
Questions (325)
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 response to the Covid-19 pandemic the HSE had to take measures to defer all non-urgent elective scheduled care activity, including outpatient clinics. This was to ensure patient safety and that all appropriate resources were made available for Covid-19 related activity and time-critical essential work. This decision was in line with the advice issued by the World Health Organisation, and the National Action Plan published on 16 March. The trajectory of the disease means there is now an opportunity for increasing the provision of non-covid care including more routine care.
My Department, the HSE and the National Treatment Purchase Fund are currently working together to estimate the impact of Covid 19 on Scheduled Care waiting lists, in order to be prepared to address any backlog or pent up demand. My Department continues to ensure that the resources available throughout our health system are best utilised at this unique and challenging time.
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 Waiting Lists
Questions (326)
Pádraig O'Sullivan
Question:326. Deputy Pádraig O'Sullivan asked the Minister for Health when a person (details supplied) will receive a date for surgery; and if he will make a statement on the matter. [9729/20]
View answerWritten 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 response to the Covid-19 pandemic the HSE had to take measures to defer all non-urgent elective scheduled care activity, including outpatient clinics. This was to ensure patient safety and that all appropriate resources were made available for Covid-19 related activity and time-critical essential work. This decision was in line with the advice issued by the World Health Organisation, and the National Action Plan published on 16 March. The trajectory of the disease means there is now an opportunity for increasing the provision of non-covid care including more routine care.
My Department, the HSE and the National Treatment Purchase Fund are currently working together to estimate the impact of Covid 19 on Scheduled Care waiting lists, in order to be prepared to address any backlog or pent up demand. My Department continues to ensure that the resources available throughout our health system are best utilised at this unique and challenging time.
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 Waiting Lists
Questions (327)
Pádraig O'Sullivan
Question:327. Deputy Pádraig O'Sullivan asked the Minister for Health his plans to reduce waiting lists and outpatient appointments at Mallow General Hospital; and if he will make a statement on the matter. [9730/20]
View answerWritten answers
In response to the Covid-19 pandemic the HSE had to take measures to defer all non-urgent elective scheduled care activity, including outpatient clinics. This was to ensure patient safety and that all appropriate resources were made available for Covid-19 related activity and time-critical essential work. This decision was in line with the advice issued by the World Health Organisation, and the National Action Plan published on 16 March. The trajectory of the disease means there is now an opportunity for increasing the provision of non-covid care including more routine care.
The National Public Health Emergency Team (NPHET) has approved a number of recommendations relating to protecting and maximising the delivery of essential time-critical non-Covid-19 care alongside Covid-19 care. On 5 May, NPHET agreed that its recommendation of 27 March, in regard to the pausing of all non-essential health services should be replaced, in relation to acute care, with a recommendation that delivery of acute care be determined by appropriate clinical and operational decision making. Application of the essential risk mitigating steps set out in the guidance developed under the auspices of the NPHET Expert Advisory group will have operational implications, which will impact on throughput.
As the system continues to deliver Covid-19 and non-Covid 19 care side-by-side over a more prolonged period, my Department and the HSE will continue to work closely together to protect essential non-Covid 19 acute care and progress the provision of more routine non Covid-19 care.
Where possible, hospitals are working to find innovative ways to enable service provision, which include virtual clinics for some out-patient department appointments. The HSE website provides details on services currently available and operational in each hospital on its website. This information is reviewed frequently and provides up-to-date announcements on services available at each site (https://www2.hse.ie/services/hospital-service-disruptions/hospital-service-disruptions-covid19.html).
In relation to specific plans to reduce waiting lists and outpatient appointments at Mallow General Hospital, I have asked the HSE to respond to the Deputy directly.
Covid-19 Pandemic
Questions (328)
Peadar Tóibín
Question:328. Deputy Peadar Tóibín asked the Minister for Health if he will address a series of matters regarding the case of a person (details supplied); and if he will make a statement on the matter. [9750/20]
View answerWritten answers
I am advised by Saolta Hospital Group that appropriate control measures are currently in place in Mayo University Hospital in relation to Covid-19.
Saolta Hospital Group has also advised that Mayo University Hospital will fully examine all of the elements of the care provided to the individual. I am informed that the General Manager of the hospital has been in contact with the person's family to advise of this, and that the process of reviewing the individual's care is underway. The hospital will be in direct contact with the individual's family in this regard.
I am also requesting a report from the CEO of the HSE on the Covid-19 measures taken at Mayo University Hospital from the outset of the pandemic, his views on the appropriateness of these measures at the particular points in time involved and his reassurance that all reasonable measures are now being taken to protect the safety of patients and staff in Mayo University Hospital.
Dental Services
Questions (329, 369)
Brendan Smith
Question:329. Deputy Brendan Smith asked the Minister for Health the progress to date in dealing with the issues outlined by an association (details supplied); if financial support will be provided to assist the sector due to the difficulties that have arisen as a result of the Covid-19 pandemic; and if he will make a statement on the matter. [9755/20]
View answer
Emer Higgins
Question:369. Deputy Emer Higgins asked the Minister for Health the supports available to dentists under financial pressures due to the requirement to restructure their practice due to Covid-19 and additional costs for PPE and the safe disposal of PPE as clinical waste; and if he will make a statement on the matter. [9089/20]
View answerWritten answers
I propose to take Questions Nos. 329 and 369 together.
Legislative amendments have been made and the Health Protection Surveillance Centre (HPSC) has worked with the dental profession and in particular the Dental Council, to provide revised guidance for the profession to allow for the resumption of the safe provision of routine care. This was in line with Phase 1 of the Government's plan for the easing of COVID-19 restrictions which commenced on 18th May. Dentists are responsible for disposing of their clinical waste in accordance with the Dental Council Code of Practice relating to Infection Prevention and Control.
The Government has put in place a suite of measures to support small, medium and larger businesses that are negatively impacted by COVID-19 including a Restart grant for which application can be made on line to local authorities. The Department of Business, Enterprise and Innovation has published a Return to Work Safely Protocol, which is designed to support employers and workers to put measures in place that will prevent the spread of COVID-19 in the workplace. The Health and Safety Authority also provides information and advice for employers and employees in this regard.
The HPSC supports the use of the normal Personal Protective Equipment (PPE) used in routine dentistry. The Dental Council has indicated that dentists should take a case by case assessment when deciding if additional PPE is warranted. I am following up with the HSE on the issue of supply of PPE for dentists.
Cannabis for Medicinal Use
Questions (330)
Seán Fleming
Question:330. Deputy Sean Fleming asked the Minister for Health the arrangements in place and the situations in which cannabis can be provided on a medicinal basis; the number of persons receiving same; and if he will make a statement on the matter. [9761/20]
View answerWritten answers
In June 2019, I signed legislation to underpin the operation of the Medical Cannabis Access Programme (MCAP). The programme will run on a 5-year pilot basis and is restricted to prescribing of cannabis-based products at medical consultant level, for those patients with certain medical conditions who have exhausted all other available treatment options. The 3 medical conditions are:
- spasticity associated with multiple sclerosis;
- intractable nausea and vomiting associated with chemotherapy;
- severe, refractory (treatment-resistant) epilepsy.
To date three products have been added to Schedule 1 of the Misuse of Drugs (Prescription and Control of Supply of Cannabis for Medical Use) Regulations 2019. While the MCAP is not currently operational, engagement is ongoing with the HSE in regard to progressing same. For more information relating to the Programme please visit the Department of Health's website.
Pending full operation of the MCAP and for medical indications not included in the MCAP, Doctors may continue to utilise the Misuse of Drugs Act Section 14 Ministerial licencing route to prescribe cannabis-based products for their patients. In line with the Chief Medical Officer's advice, the granting of a licence for cannabis for medical purposes must be premised on an appropriate application being submitted to the Department of Health, which is endorsed by a consultant who is responsible for the management of the patient and who is prepared to monitor the effects of the treatment over time.
This information, including the clinical guidelines, can also be found on the Department's website at the following address:
https://www.gov.ie/en/collection/fb8912-cannabis-for-medical-use/
It is important to note that the medical decision to prescribe or not prescribe any treatment, including cannabis treatment, for an individual patient is strictly a decision for the treating clinician, in consultation with their patient. I have no role in this clinical decision-making process.
To date, clinicians for thirty-five individual patients have received a Ministerial Licence under Section 14 of the Misuse of Drugs Act.
Questions Nos. 331 to 333, inclusive, answered with Question No. 318.
Medical Cards
Questions (334, 335)
Paul McAuliffe
Question:334. Deputy Paul McAuliffe asked the Minister for Health his views on a situation (details supplied) regarding the medical card. [9773/20]
View answerPaul McAuliffe
Question:335. Deputy Paul McAuliffe asked the Minister for Health the reason patients with a medical card that pay to attend a particular general practitioner out of choice are not entitled to have prescribed medicines covered by the medical card. [9774/20]
View answerWritten answers
I propose to take Questions Nos. 334 and 335 together.
The Irish Public Health System provides for two categories of eligibility for persons ordinarily resident in the country, i.e. full eligibility (medical cards) and limited eligibility. Full eligibility is determined primarily by reference to income limits. Determination of an individuals eligibility status is the responsibility of the HSE.
Individuals with full eligibility can access a range of services including General Practitioner services, prescribed drugs and medicines, all in-patient public hospital services in public wards, including consultant services, all out-patient public hospital services including consultant services, dental, ophthalmic and aural services and appliances and a maternity and infant care service.Individuals with limited eligibility are eligible for in-patient and outpatient public hospital services including consultant services, subject to certain charges. Other services such as allied healthcare professional services may also be made available to persons with limited eligibility.
A General Practitioner (GP) Visit Card provides for eligible individuals to visit a participating GP service without fees and also covers visits to GP out-of-hours service. GP's are independent practitioners, many of whom hold contracts with the HSE for the provision of services to medical card and GP visit card holders. It should be noted that all individuals over the age of 70 are automatically eligible for a GP visit card.
Individuals with full eligibility who access services from a GP who holds a GMS Contract with the HSE are eligible to have their prescribed medicines provided free subject to the application of the prescription charge. Persons who elect to attend a GP that does not hold a contract with the HSE may apply to avail of the Drugs Payment Scheme which provides for a maximum payment of €124 per month for approved prescribed drugs, medicines and certain appliances for themselves and/or their family. This scheme significantly reduces the cost burden for families and individuals with ongoing expenditure on medicines.
Covid-19 Pandemic
Questions (336)
Dara Calleary
Question:336. Deputy Dara Calleary asked the Minister for Health the impact analysis carried out before the decision on a two week quarantine was taken; if consideration was given to the impact this will have on those commuting to work, for example, in the UK on a weekly basis, to persons that may travel home for occasional weekends with families and to persons that may have to travel home for a family emergency; and if he will make a statement on the matter. [9776/20]
View answerWritten answers
The measures taken are underpinned by a clear public health rationale.
As the number of indigenous cases here declines and Ireland eases some restrictions, the relative importance of the risk of importation of cases from overseas increases. Ultimately, the progress towards suppression of community transmission which has been achieved and which should allow for greater resumption of social and economic life in Ireland could be endangered.
The public health advice for passengers arriving into the State from overseas is to self-isolate for 14 days.
By contrast, since 28 May, it is a legal requirement for passengers arriving from overseas to complete a COVID-19 Passenger Locator Form. The information on the form may be used to assist our contact tracing teams.
The issue of imposing mandatory self-isolation for a 14-day period, to be considered as the situation evolves, was mentioned in the Roadmap for Reopening Society & Business. My Department, in consultation with other relevant Departments including the Department of Transport, Tourism and Sport, is developing proposals to strengthen the 14-day self-isolation arrangements for travellers from overseas. Careful consideration is being given to exemptions to any mandatory regime of quarantine.
Any mandatory arrangements would be kept under regular review.
Covid-19 Pandemic
Questions (337)
John Lahart
Question:337. Deputy John Lahart asked the Minister for Health if consideration will be given to allowing persons with holiday homes outside the 20 km zone to be given permission to travel to them to carry out essential maintenance and upkeep on these homes earlier than the anticipated date in the Roadmap for Reopening Society and Business; and if he will make a statement on the matter. [9777/20]
View answerWritten answers
The Government’s Roadmap for Reopening Society & Business, published on 1 May 2020, sets out an indicative path to the easing of COVID 19 restrictions and other actions in order to facilitate the reopening of Ireland’s society and economy in a phased manner. Phase 1 was introduced on 18 May 2020 and, as the Deputy is aware, the Government confirmed the move to Phase 2 of Roadmap for Reopening Society & Business from Monday, 8 June 2020. Information and advice about the restrictions that have been eased as part of Phase 2 and the measures that are now in place are available on the Government website at http://www.gov.ie/phase2.
The Roadmap specifies that decisions in relation to which actions will be taken and which public health measures might be lifted will be made in accordance with the Framework for Future Decision-Making which is as follows:
1. Before each Government consideration of the easing of restrictions, the Department of Health will provide a report to the Government regarding the following on/off trigger criteria:
a. The latest data regarding the progression of the disease,
b. The capacity and resilience of the health service in terms of hospital and ICU occupancy,
c. The capacity of the programme of sampling, testing and contact tracing,
d. The ability to shield and care for at risk groups,
e. An assessment of the risk of secondary morbidity and mortality as a consequence of the restrictions.
2. It will also provide risk-based public health advice on what measures could be modified in the next period.
3. The Government would then consider what restrictions could be lifted, having regard to the advice of the Department of Health as well as other social and economic considerations, e.g. the potential for increased employment, relative benefits for citizens and businesses, improving national morale and wellbeing etc.
4. It is acknowledged that there is also an ongoing possibility that restrictions could be re-imposed and this process will be carried out on an ongoing basis once every 3 weeks.
As is clear from the framework described above, it is the Government rather than I or my Department that will decide on any modifications to the current public health measures in place and those decisions will be informed by the status of the on/off trigger criteria and the public health advice received at the time that a decision is being made.
The current public health advice regarding travel is that people are asked to stay local. People may travel within their own county, or 20 kilometres from home if crossing county boundaries, to visit local venues or amenities such as parks and shops that have reopened as part of the Government’s Roadmap. The regulatory framework underpinning this public health advice is Health Act 1947 (Section 31A - Temporary Restrictions) (COVID-19) (No. 2) Regulations 2020 (SI No. 206 of 2020). Travel for essential purposes is permitted under the regulations.
Hospital Services
Questions (338)
Paul Murphy
Question:338. Deputy Paul Murphy asked the Minister for Health when outpatient appointments will recommence in view of the cancellation and postponement of many due to the Covid-19 crisis. [9794/20]
View answerWritten answers
In response to the Covid-19 pandemic the HSE had to take measures to defer all non-urgent elective scheduled care activity, including outpatient clinics. This was to ensure patient safety and that all appropriate resources were made available for Covid-19 related activity and time-critical essential work. This decision was in line with the advice issued by the World Health Organisation, and the National Action Plan published on 16 March. The trajectory of the disease means there is now an opportunity for increasing the provision of non-covid care including more routine care.
The National Public Health Emergency Team (NPHET) has approved a number of recommendations relating to protecting and maximising the delivery of essential time-critical non-Covid-19 care alongside Covid-19 care. On 5 May, NPHET agreed that its recommendation of 27 March, in regard to the pausing of all non-essential health services should be replaced, in relation to acute care, with a recommendation that delivery of acute care be determined by appropriate clinical and operational decision making. Application of the essential risk mitigating steps set out in the guidance developed under the auspices of the NPHET Expert Advisory group will have operational implications, which will impact on throughput.
Where possible, hospitals are working to find innovative ways to enable service provision, which include virtual clinics for some outpatient department appointments. The HSE website provides details on services currently available and operational in each hospital on its website. This information is reviewed frequently and provides up-to-date announcements on services available at each site (https://www2.hse.ie/services/hospital-service-disruptions/hospital-service-disruptions-covid19.html).
Paediatric Services
Questions (339)
Duncan Smith
Question:339. Deputy Duncan Smith asked the Minister for Health when paediatric occupational therapists and speech and language therapists can reopen their centres and begin operations again; and if he will make a statement on the matter. [9804/20]
View answerWritten answers
As the Deputy's question relates to a service issue, it has been referred to the HSE for direct reply.
Hospital Services
Questions (340)
Duncan Smith
Question:340. Deputy Duncan Smith asked the Minister for Health when he expects to allow gynaecologists to return to operation; and if he will make a statement on the matter. [9805/20]
View answerWritten answers
As the Deputy may be aware, in late March, the National Public Health Emergency Team (NPHET) recommended that all non-essential health services should be paused to protect and maximise the delivery of essential time-critical care during the COVID-19 pandemic. However, on 5 May last the NPHET replaced its previous recommendation with a new recommendation that, going forward, the delivery of acute care should be determined by appropriate clinical and operational decision making.
I have asked the Health Service Executive to respond directly to the Deputy on the specific question relating to the resumption of gynaecology services.
General Practitioner Services
Questions (341)
Duncan Smith
Question:341. Deputy Duncan Smith asked the Minister for Health when he expects to allow general practitioners to return to operation; and if he will make a statement on the matter. [9806/20]
View answerWritten answers
I wish to assure the Deputy that general practice is has continued to operate during the public health emergency and GPs are still seeing patients where necessary, albeit with infection-control measures in place.
However, the exceptional circumstances faced by medical practitioners during the COVID-19 pandemic has resulted in a change in how GP services are delivered. At this time, walk-in clinics are not generally being provided and patients are asked to phone their GP initially to discuss their medical problem. GPs are performing assessments over the phone to determine if a patient needs to attend the surgery. Many problems can be resolved over the phone or by video consultation, some can be helped by the secure transfer of a prescription to the pharmacist while others may need referral to other services. Where clinically indicated, the GP will arrange an appointment to see the patient in the surgery. These measures are necessary to ensure the safety of patients, GPs, and practice staff.
Health Insurance
Questions (342)
Robert Troy
Question:342. Deputy Robert Troy asked the Minister for Health his plans in relation to persons that have private health insurance but are unable to access same due to the State contract with private hospitals; and if he will make a statement on the matter. [9821/20]
View answerWritten answers
A major part of the Government's Action Plan in response to Covid-19 was to substantially increase the capacity of public healthcare facilities to cope with the anticipated additional demand. In order to urgently ramp up capacity for acute care facilities, an arrangement was agreed with the private hospitals to use their facilities as part of the public system on a temporary basis, to provide essential services. A Heads of Terms of Agreement between the HSE and the Private Hospitals was agreed at the end of March 2020 and all 18 of the acute private hospitals signed up to it. Under the arrangement, all patients in the private hospitals are treated as public patients and their treatment is prioritised based on clinical need. Provision was made under the agreement to allow for continuity of care for patients who were in a private hospital or attending for treatment at the time the Heads of Terms of Agreement were agreed, on the grounds that these patients would be treated as public patients.
Department officials engaged with the insurers at the outset of the private hospitals agreement. In order to assist health insurance customers impacted by the Covid-19 national response, each of the insurers have announced a range of supportive measures for their customers.
The agreement was reviewed at the end of May and the Government decided that the existing arrangement should not be extended beyond the end of June. It has however mandated the HSE to negotiate a new arrangement with private hospitals which would provide the HSE with full access to private hospital capacity in the event of a surge of Covid-19 and separately with ongoing agreed access, to enable the HSE to meet essential and elective care needs
In response to the COVID-19 pandemic the HSE had to take measures to defer all non-urgent elective scheduled care activity, including outpatient clinics. This was to ensure patient safety and that all appropriate resources were made available for COVID-19 related activity and time-critical essential work. This decision was in line with the advice issued by the World Health Organisation, the measures set out in the Action Plan in Response to Covid-19 and the recommendation of NPHET. The NPHET has now recommended that steps be taken to resume non-urgent scheduled care in the context of the safe care guidelines set out by its Expert Advisory Group.
Health Screening Programmes
Questions (343)
Catherine Murphy
Question:343. Deputy Catherine Murphy asked the Minister for Health if a risk assessment was carried out in relation to the cessation and or pause of routine cancer screening services; if he has developed a roadmap to the commencement of these screening services; if so, if he will publish it; and if he will make a statement on the matter. [9822/20]
View answerWritten answers
As this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
Primary Care Centres
Questions (344)
John Lahart
Question:344. Deputy John Lahart asked the Minister for Health the status of the provision of a primary care centre at a location (details supplied); when construction can begin on the site; and the facilities which will be available to the public therein. [9823/20]
View answerWritten answers
As the Health Service Executive is responsible for the delivery of public healthcare infrastructure projects, I have asked the HSE to respond to you directly in relation to this matter.