Written Answers Nos. 613-637
613. Deputy Johnny Mythen asked the Minister for Health if he will consider revising the Roadmap for Reopening Society and Business to allow physiotherapists, barbers, beauticians, tattoo artists, piercers, fitness instructors and similar professional services to open on an appointment only basis behind closed doors and with the use of adequate personal protective equipment on 29 June 2020 (details supplied). [11056/20]
View answerThe 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 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:
1. The latest data regarding the progression of the disease,
2. The capacity and resilience of the health service in terms of hospital and ICU occupancy,
3. The capacity of the programme of sampling, testing and contact tracing,
4. The ability to shield and care for at risk groups,
2. An assessment of the risk of secondary morbidity and mortality as a consequence of the restrictions.
3. It will also provide risk-based public health advice on what measures could be modified in the next period.
4. 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.
5. 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 the Minister or Department of Health 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 decisions of the Government are published and the guidance in operation at a point in time are available on the Government website at http://www.gov.ie/
Physiotherapists are members of a designated profession within the meaning of section 3 of the Health and Social Care Professionals Act 2005 (No. 27 of 2005) and have been and continue to be permitted to operate in accordance with the Regulations.
I would like to draw the Deputy's attention to the Health Act 1947 (Section 31A - Temporary Restrictions) (Covid-19) (No. 2) Regulations 2020 (SI No. 206 of 2020) signed by me, which came into operation on 8 June 2020 until 29 June 2020. The new Regulations provide for the unwinding of certain restrictions provided for in the earlier Regulations and also provide for continued restrictions for some business and services.
A number of the other services mentioned by the Deputy are addressed within the Regulations. The purpose of this regulatory approach to the implementation of the public health framework is to inform a slow, gradual, step-wise and incremental reduction of the current public health social distancing measures, in a risk-based, fair and proportionate way with a view to effectively suppressing the spread of COVID-19 disease while enabling the gradual return of social and economic activity. The Government, informed by the public health advice provided by the Department of Health, has decided to take a gradual re-opening of society and the economy as risks to human health and life caused by COVID-19 remain and lifting the measures in place carries considerable great uncertainty and risk.
The Government also agreed to bring forward actions in the remaining phases of the Roadmap and plan for four phases rather than the five originally indicated. Work is underway to consider how best to achieve this aim and more information will be made available in the coming weeks. This work, once completed will form part of the Government's considerations.
614. Deputy Johnny Mythen asked the Minister for Health if temporary changes can be made to models of care to allow doctors or nurses administer intravenous drips in the residential care setting in order to keep patients out of hospital and reduce the risk of exposure to Covid-19. [11061/20]
View answerAdministration of IV therapies comes within the scope of practice for every nurse. However, it is essential, as with any skill, that competency is maintained through regular practice and education. Administration of Intravenous fluids or medication by nursing staff in any care setting is governed by local policy and should take account of the frequency any such therapy will require. The model of care is determined by the relevant National Clinical Programme.
Any patient or nursing home resident requiring IV fluid therapy is acutely unwell and will require other nursing care to support their illness. This care will require education and support as it is in addition to normal care requirements.
A Community Intervention Team (CIT) is a specialist, health professional team that provides a rapid and integrated response to a patient with an acute episode of illness who requires enhanced services/acute intervention for a defined short period of time. This may be provided at home, in a residential setting or in the community as deemed appropriate, thereby avoiding acute hospital attendance or admission, or facilitating early discharge.
One of the services includes administration of IV Antibiotic - via the Outpatient Parenteral Antimicrobial Therapy Program (OPAT). The OPAT national standards require that an infection specialist (Infectious disease/ Clinical Microbiologist) is consulted on the appropriateness of a prescription for IV antibiotics, the dose and duration, in order to ensure antimicrobial stewardship. CIT or OPAT nurses are available to facilitate a referral from the emergency department to avoid hospital admission, or from hospitals wards to facilitate early discharge and return to the person’s place of residence for the course of their IV antibiotics. A pathway is in place for GPs to refer appropriate patients directly for IV antibiotics for cellulitis.
Finally, I wish to advise the Deputy that on foot of a National Public Health Emergency Team (NPHET) recommendation, on 23 May a COVID-19 Expert Panel on Nursing Homes was established, to examine the complex issues surrounding the management of COVID-19 among this particularly vulnerable cohort.
The purpose of the Panel is to examine the national and international responses to the COVID-19 crisis, and to examine the emerging best practice. The main objective of the Panel is to provide immediate real-time learnings and recommendations in light of the expected ongoing impact of COVID-19 over the next 12-18 months. COVID-19 is a new disease, which can present atypically in the frail elderly, and new evidence and best practice in its management are constantly emerging.
615. Deputy Patrick Costello asked the Minister for Health the status of the work his officials are carrying out on the national adult safeguarding policy for the health sector; when adult safeguarding and an independent advocacy service will be in place nationally; and if he will make a statement on the matter. [11067/20]
View answerThe safety and protection of all those who may be at risk of harm or abuse is an important priority for the Government. In the health sector, a framework of standards, policies and procedures for the safeguarding of adults who may be at risk of abuse, harm and exploitation within the health sector is in place, and further measures are being developed to strengthen this framework.
The development of a new national policy on adult safeguarding in the health sector was approved by Government. The development of policy in this area is a complex undertaking which involves consideration of a wide range of issues (including, as appropriate, advocacy issues in respect of the health and social care sector).
This national sectoral policy will apply across the full spectrum of the Irish healthcare and social care sector including all public, voluntary and private health and social care services and settings and will include proposals on collaboration, information-sharing and referral arrangements between the health sector and other key sectors.
My Department is progressing this work. Significant policy development work, including stakeholder engagement and detailed research, has been undertaken, although in common with other projects, there has been some degree of disruption arising from the Department’s and the wider health system’s lead role in responding to the COVID-19 pandemic. Notwithstanding this, it is hoped to circulate a draft policy for public consultation later this year with a view to submitting a final version of a policy to Government thereafter. Following analysis and consideration of the feedback obtained through the consultation process the draft policy will be further developed and proposals on the policy will be submitted to Government thereafter.
Evidence base and policy development has progressed well to date. For example:
- A high-level Steering Group was established to assist my Department in its development of the policy and has held 7 meetings to date, most recently, by tele-conference, on Friday 12 June. Updates and related papers such as discussion papers on the policy content are published regularly on my Department's website.
- Focus group consultation research was undertaken between November 2019 and March 2020 by the Institute of Public Health on my Department’s behalf, to ensure that the voices of the most directly affected service users are heard. The Institute’s final report to the Department on the focus group research is scheduled for completion later this Summer.
- A commissioned independent research evidence project to inform the policy is in the final stages of completion.
Related major developments in relation to other adult safeguarding policy developments within the health and social care sector include:
- My approval in September 2019, and subsequent publication, of National Standards for Adult Safeguarding prepared and submitted to me jointly by HIQA and the Mental Health Commission.
- The anticipated finalisation of a major revision by the Health Service Executive of its national operational HSE adult safeguarding policy.
These initiatives, together with the Department’s development of the national health sector policy and underpinning legislation, should ensure the continued evolution and improvement, within the Irish health and social care sector, of the safeguarding of adults who may be at risk of abuse and harm.
A further significant initiative in relation to adult safeguarding (relevant to all sectors and Departments, including the health and social care sector and my Department) was the Law Reform Commission's commencement in June 2019 of a legal research project on "A Regulatory Framework for Adult Safeguarding", on foot of submissions from various bodies, including from my Department. I understand that this work is progressing having regard to a recent consultation process.
I have previously emphasised the importance of developing a clear, coherent, carefully-considered and implementable policy framework as a basis for any required underpinning legislation. The Department's approach therefore has been to undertake the required detailed policy and evidence base development work including appropriate research, public and stakeholder consultation and resource implications analyses.
616. Deputy Johnny Guirke asked the Minister for Health the steps he will be taking to ensure PPE is made available to essential healthcare support organisations, such as an organisation (details supplied); and if he will make a statement on the matter. [11073/20]
View answerThe provision of sufficient levels of PPE to essential healthcare organisations is a service matter for the Health Service Executive in the first instance. I have, therefore, asked the HSE to reply to you directly.
617. Deputy Peadar Tóibín asked the Minister for Health if he will review the reopening date for the cinema industry; if the reopening of the sector will be brought forward in line with the industry in other European countries and Northern Ireland by allowing cinemas to adopt the measures already presented to his Department to meet the necessary challenges; and if he will make a statement on the matter. [11075/20]
View answerThe 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 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:
1. The latest data regarding the progression of the disease,
2. The capacity and resilience of the health service in terms of hospital and ICU occupancy,
3. The capacity of the programme of sampling, testing and contact tracing,
4. The ability to shield and care for at risk groups,
5. 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 the Minister or Department of Health 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 decisions of the Government are published and the guidance in operation at a point in time are available on the Government website at http://www.gov.ie/
The purpose of this public health framework approach is to inform a slow, gradual, step-wise and incremental reduction of the current public health social distancing measures, in a risk-based, fair and proportionate way with a view to effectively suppressing the spread of COVID-19 disease while enabling the gradual return of social and economic activity.
The services described in the Deputy’s question is not a matter within the remit of my Department. Guidance in relation to specific sectors of the economy should in the first instance be sought from the Government Department with responsibility for that sector.
However, the Deputy may wish to note that Regulation 7(1) of the newly introduced Health Act 1947 (Section 31 A - Temporary Restrictions) (Covid-19) (No. 2) Regulations 2020 provides that the occupier, manager, or any other person in charge shall take all reasonable steps to ensure that members of the public are not permitted, or otherwise granted, access to a premises, or to a part of such premises, where a relevant business or service is carried on or otherwise provided. The relevant businesses or services to which this provision applies are listed in Schedule 2 of the regulation and includes cinemas, other than outdoor cinemas at which persons attending a screening do so in motor vehicles and remain in the vehicles without exiting the motor vehicles for the duration of such attendance.
The Government also agreed to bring forward actions in the remaining phases of the Roadmap and plan for four phases rather than the five originally indicated. Work is underway to consider how best to achieve this aim and more information will be made available in the coming weeks.
618. Deputy Rose Conway-Walsh asked the Minister for Health the number of times it has taken an ambulance more than 20, 40 minutes and more than one hour to reach patients that made emergency calls in County Mayo; the longest ambulance response time logged in County Mayo; and if he will make a statement on the matter. [11082/20]
View answerAs this is a service matter I have asked the Health Service Executive to reply to you directly.
620. Deputy Louise O'Reilly asked the Minister for Health if his attention has been drawn to a petition by a person (details supplied) regarding cervical screening requesting immediate reinstatement of cervical smear testing; and if a commitment will be given to reinstate the cervical cancer screening as soon as possible. [11107/20]
View answerSince COVID 19 was categorised as a national public health emergency the Health Service Executive (HSE) had to take measures to defer all non-urgent care to ensure staff and patient safety and to minimise the spread of COVID 19. In line with this the National Screening Service (NSS) had to take the very difficult decision to pause all four population screening programmes, including CervicalCheck. These measures were in alignment with the National Public Health Emergency Team’s (NPHET) recommendations which have as their goal to minimise the spread of COVID 19.
The HSE are currently planning the resumption of regular health services and are developing capacity planning for the ongoing delivery of COVID-19 and non-COVID-19 care and services side by side.
The NSS is participating in this national process, led jointly by the Chief Clinical Officer and the Chief Operations Officer in the HSE to restore services safely across all parts of the healthcare system. NSS Director of Public Health, Dr Caroline Mason Mohan, is NSS clinical representative on the HSE steering group which is ensuring a coordinated approach to the resumption of non-COVID related health services.
I am aware the correspondence the Deputy is referring to which has been received in my office. The resumption of screening is a priority for the NSS, it requires very careful planning to ensure that our population screening services can be delivered in a safe way. Screening will be re-introduced on a phased basis, with invitations for screening issued according to clinical prioritisation and taking the screening and treatment pathways into account. It is expected that restart dates for population screening will be announced by the end of June.
621. Deputy Louise O'Reilly asked the Minister for Health the status of the establishment of the CervicalCheck tribunal; when it will be formed; and if he will make a statement on the matter. [11109/20]
View answerIn December 2018 the Government agreed to set up a statutory Tribunal to provide an alternative system for dealing with claims arising from CervicalCheck. The Government also announced that Ms. Justice Mary Irvine would be appointed as Chairperson of the Tribunal.
The legislation necessary to establish the CervicalCheck Tribunal, the CervicalCheck Tribunal Act 2019, passed through the Oireachtas and was signed into law by the President on 23 July 2019. The legislation sets out the functions of the Tribunal, which include hearing and determining claims in respect of CervicalCheck outside of the court process and facilitating Restoration of Trust Meetings.
For the Tribunal to begin carrying out its functions, Section 4 of the Act requires that ‘The Minister shall, by order, appoint a day to be the establishment day for the purposes of this Act.’
Since the passage of the legislation through the Oireachtas, Department officials have been working with Tribunal Chairperson making the administrative arrangements required to establish the CervicalCheck Tribunal.
As the key administrative arrangements were in place, it was intended that the CervicalCheck Tribunal would be established by the end of March 2020. However, due to the outbreak of Covid-19, in line with the public health measures being taken to control the outbreak of the virus it was decided to delay the establishment of the Tribunal. Of particular concern in establishing the Tribunal is that the claimants are in a group considered to be particularly at risk if they were to contract the virus.
As the restrictions are now being eased and arrangements are being put in place in the Tribunal to ensure it can operate as safely as possible, it is expected that the Tribunal will be established shortly. It is intended that the Tribunal’s function in respect of hearing and determining claims will be commenced initially and its function in respect of Restoration of Trust Meetings will be commenced at a later stage.
Once a date for the establishment of the Tribunal has been decided, it will be announced on the Tribunal website www.cervicalchecktribunal.ie and will communicated directly to the relevant parties.
622. Deputy Louise O'Reilly asked the Minister for Health the number of baby developmental checks carried out in the first five months of 2020; and the way in which this compares to the first five months of 2018 and 2019, respectively. [11111/20]
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.
623. Deputy Louise O'Reilly asked the Minister for Health the number of childhood vaccinations delivered in the first five months of the year; and the way in which this compares to the first five months of 2018 and 2019, respectively. [11112/20]
View answerAs the Health Service Executive collects and collates immunisation statistics, I have asked them to reply directly to the Deputy.
624. Deputy Louise O'Reilly asked the Minister for Health when respite care will begin to be reinstated to give family carers some much needed help. [11113/20]
View answerThe Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose and enhance their ability to tailor the supports required to meet their needs and plan their lives. This commitment is outlined in the Programme for Partnership Government, which is guided by two principles: equality of opportunity and improving the quality of life for people with disabilities.
The Programme for Partnership Government states that the Government wishes to provide more accessible respite care to facilitate full support for people with a disability.
As the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy
625. Deputy Louise O'Reilly asked the Minister for Health further to the discussion in the Dáil Éireann on 4 June 2020, if the public health system may have to close between 20% to 25% of public hospital beds under new infection control measures for dealing with Covid-19; if so, the number of beds that will be closed in each hospital in tabular form; and if he will make a statement on the matter. [11119/20]
View answerThe HSE has advised that it is working to develop plans for service continuity across all settings, including acute settings. Infection prevention and control (IPC) is a core part of this work, which includes consideration of the impact of necessary IPC measures on capacity as well as of opportunities for alternative service models and pathways. This work is ongoing.
626. Deputy Louise O'Reilly asked the Minister for Health the number of persons that have been employed in the health service through the Be on Call for Ireland initiative; and the locations to which they have been posted by hospital or community health organisation in tabular form. [11120/20]
View answerI have asked the HSE to respond to the Deputy directly on this matter.
627. Deputy Jackie Cahill asked the Minister for Health when the cardiology department in Nenagh Hospital, County Tipperary will be up and running; and if he will make a statement on the matter. [11123/20]
View answerAs this is a service issue, I have asked the Health Service Executive to reply to you directly.
628. Deputy Marc MacSharry asked the Minister for Health if the Covid-19 contact tracing application due to be launched shortly will be accessible to visually impaired persons; and if he will make a statement on the matter. [11165/20]
View answerContact tracing operations are at the centre of the health service response to Covid-19 and protecting our communities in the phases ahead. Key to effective contact tracing is the capacity to get quick and comprehensive notification to all close contacts of people infected with Covid-19. The Covid Tracker app has been developed to complement our current arrangements and help improve the speed and comprehensiveness of contact tracing. It is core to the purposes of the app that it be as accessible as possible to the whole population (aged 16 and over).
The primary purpose of the app is to enable the health services to improve the speed and effectiveness of contact tracing. Use of the app will provide for more comprehensive alerting of close contacts of those that have become infected than is currently possible based on interviews of those infected and memory recall. In addition, the app permits citizens to anonymously report symptoms in real-time. The purpose of the symptom tracker is to assist the health services in mapping, predicting and ultimately preventing the spread of Covid-19. The app will also provide direct access to authoritative news, the purpose of which is to ensure that information and up-to-date guidance in relation to Covid-19 is accessible.
The development team has engaged with the National Council for the Blind Ireland (NCBI) and contracted them to carry out an assessment of the app for those with visual impairments. The team are addressing issues arising from that assessment and in order of priority, so that version 1 of the app will be functional for use by those with visual and physical challenges. Further enhancements will be addressed in subsequent releases of the app.
629. Deputy Louise O'Reilly asked the Minister for Health the amount spent on the Be on Call for Ireland campaign. [11167/20]
View answerI have asked the HSE to respond to the Deputy directly on this matter.
630. Deputy Róisín Shortall asked the Minister for Health the position regarding appointments for a child (details supplied) in Dublin 11; the reason for the delay; and if he will make a statement on the matter. [11177/20]
View answerAs the Deputy's question relates to a service issue, it has been referred to the HSE for direct reply.
631. Deputy Róisín Shortall asked the Minister for Health the number of persons living in direct provision that were offered an isolation room in a hotel (details supplied) since the HSE took over the hotel in April 2020; the number of persons living in direct provision that moved into a room in the hotel during the same period; and if he will make a statement on the matter. [11178/20]
View answerAs the Deputy’s questions relate to a service matter it has been referred to the HSE for answer and direct reply to the Deputy.
632. Deputy Róisín Shortall asked the Minister for Health the number of hospital patients transferred to nursing homes since 1 March 2020; and the number of transfers each week in tabular form. [11179/20]
View answerAs this is a service matter, I have asked the HSE to respond to the Deputy directly.
633. Deputy Róisín Shortall asked the Minister for Health the number of nursing home residents that were transferred to an isolation room in a hotel (details supplied) since 1 March 2020; and the number of transfers each week in tabular form. [11180/20]
View answerAs this is a matter for the Health Service Executive, I have asked them to respond to you directly.
634. Deputy Róisín Shortall asked the Minister for Health the number of persons living in emergency accommodation that were offered an isolation room in a hotel (details supplied) since the HSE took over the hotel in April 2020; the number of persons living in emergency accommodation that moved into a room in the hotel during the same period; and if he will make a statement on the matter. [11182/20]
View answer636. Deputy Róisín Shortall asked the Minister for Health the number of incoming overseas passengers offered an isolation room at a hotel (details supplied) since 1 March 2020; and the number each week since in tabular form. [11184/20]
View answer637. Deputy Róisín Shortall asked the Minister for Health the number of frontline workers offered an isolation room at a hotel (details supplied) since 1 March 2020; and the number each week since in tabular form. [11185/20]
View answer647. Deputy Paul McAuliffe asked the Minister for Health the cost of the hire of private hotel rooms for Covid-19 cases in a hotel (details supplied) to the HSE or his Department each month. [11219/20]
View answerI propose to take Questions Nos. 634, 636, 637 and 647 together.
As this is an operational matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
635. Deputy Róisín Shortall asked the Minister for Health if the field hospital set up at a convention centre (details supplied) can be used to alleviate waiting lists to the end of October 2020; and if he will make a statement on the matter. [11183/20]
View answerIn 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 National Public Health Emergency Team (NPHET), 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).
In relation to the use of the Convention Centre, I have asked the HSE to respond to the Deputy directly.
