Written Answers Nos. 688-712
688. Deputy Dessie Ellis asked the Minister for Health the options available which will be explored for the banning of the use or sale of nitrous oxide capsules, also known as hippie crack (details supplied); and if he will make a statement on the matter. [11455/20]
View answerNitrous Oxide has various legitimate uses, medical, non-medical and industrial and because of its legitimate uses it is not controlled under the Misuse of Drugs Acts 1977-2016 or under the International Drug Conventions.
Under Section 3 of the Criminal Justice (Psychoactive Substances) Act 2010 it is an offence to, inter, sell, import or export a psychoactive substance for human consumption, including Nitrous Oxide.
The Criminal Justice Psychoactive Substances Act 2010 is the responsibility of the Department of Justice and Equality and the matter would be more appropriately directed to that Department.
689. Deputy Dessie Ellis asked the Minister for Health the measures that will be put in place to deal with the increasing number of deaths by suicide and the increase in those presenting with suicidal ideation resulting from measures implemented to deal with the Covid-19 pandemic; and if he will make a statement on the matter. [11456/20]
View answerThe Covid-19 pandemic has caused significant stress, anxiety, worry and fear for many people and we need to ensure that our mental health services are capable of meeting any potential increase in demand. In recognition of this, the Government has mobilised key cross-Government and cross-sectoral partners to develop a mental wellbeing campaign.
The campaign is a whole-of-population approach to supporting healthcare staff and the public, through health and wellbeing advice, resilience-based training and free online interventions such as counselling and crisis texting for all in need. In addition, the HSE’s online mental health services have been providing remote access to supports during the Covid-19 outbreak and will continue to be available in the post-Covid phase.
There is concern globally that the Covid-19 pandemic may increase suicide rates. High-quality evidence is needed to guide both national and international responses to the pandemic. The HSE National Office for Suicide Prevention (NOSP) is working with partners to address suicide prevention during and after Covid-19. NOSP and the National Suicide Research Foundation have been working with colleagues in Scotland undertaking a literature review on public health emergencies and suicidal behaviour, in order to provide the HSE with research-based intelligence about the likely impact of the current Covid-19 pandemic on suicidal behaviour.
690. Deputy Mary Butler asked the Minister for Health the position regarding the administering of results of cancer screening services for those who received tests prior to the suspension in services due to the Covid-19 pandemic (details supplied); the figures for results which have been administered; the timeline for the circulation of remaining results which may be outstanding; and if he will make a statement on the matter. [11461/20]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
691. Deputy Louise O'Reilly asked the Minister for Health if the State will secure and provide face masks in order that the public can comply with public health advice. [11474/20]
View answer692. Deputy Louise O'Reilly asked the Minister for Health if he has given consideration to providing each household with a regular supply of face masks as has been done in many south-east Asian countries to reduce outbreaks of Covid-19; and if he will make a statement on the matter. [11475/20]
View answer724. Deputy Darren O'Rourke asked the Minister for Health the current advice on the wearing of face coverings in public; if it is mandatory with limited exceptions; and if he will make a statement on the matter. [11618/20]
View answerI propose to take Questions Nos. 691, 692 and 724 together.
The National Public Health Emergency Team (NPHET) provided guidance in relation to face coverings in its advice to Government in relation to Phase 2 of the Roadmap for Reopening Business & Society on 4 June. The current public health advice in Ireland in relation to masks and face coverings is consistent with the recently updated WHO advice on this topic.
The NPHET advice sets out circumstances under which the wearing of a non-medical face covering is recommended. These are when using busy public transport, when in indoor public areas including retail outlets, by people visiting the homes of those who are cocooning, by people who are being visited in their homes by those who are cocooning, all visitors to residential care facilities and in indoor work environments where it is difficult to maintain 2 metre distance.
The wearing of face coverings in other environments should accommodate individual judgement or preference, or where it is difficult to maintain a 2-metre distance.
The current Government advice on face coverings and how to make, care and wear face coverings at home is available on the Government website at https://www.gov.ie/en/publication/aac74c-guidance-on-safe-use-of-face-coverings/. It is also available on the Health Service Executive website at https://www2.hse.ie/conditions/coronavirus/face-masks-disposable-gloves.html. There are currently no plans to distribute face masks in the manner described.
The NPHET advice emphasises that the wearing of face coverings is an additional hygiene measure and should not take the place of good hand hygiene, respiratory etiquette and other personal protective public health measures. It also emphasises that it is important to use face coverings properly, in line with the guidance and wash your hands before putting them on and taking them off.
This advice is kept under review by the NPHET on a continuing basis.
693. Deputy Louise O'Reilly asked the Minister for Health the reason the genetic material and data of patients who had a brain tissue sample taken in Beaumont Hospital between 1987 and 2018 is being given to an organisation (details supplied). [11476/20]
View answer694. Deputy Louise O'Reilly asked the Minister for Health the reason patients who had a brain tissue sample taken in Beaumont Hospital between 1987 and 2018 must opt-out instead of opt-in to consent for their genetic material and data to be given to an organisation (details supplied). [11477/20]
View answer722. Deputy Louise O'Reilly asked the Minister for Health the reason there was not a greater onus on a company (details supplied) to make patients or family members of patients aware that the genetic material and data of patients who had a brain tissue sample taken in Beaumont Hospital between 1987 and 2018 was to be given to it as of 12 June 2020. [11596/20]
View answerI propose to take Questions Nos. 693, 694 and 722 together.
The Minister for Health does not make decisions in individual cases of health research. However, I can set out the regulatory and ethical processes that apply in relation to carrying out health research in Ireland.
Persons are free to carry out health research as long as it complies with the law and applicable ethical requirements. That means that, in practice, all health research in Ireland has to be ethically approved by research ethics committees. Those committees are composed of expert and lay members to ensure a wide-ranging societal and scientific perspective is applied to consideration of the research. Some health research involves collaboration between hospitals, academic institutions and commercial companies. That collaboration is predicated on the view that each participating partner brings a distinct value to the research. If hospitals or academic institutions wish to collaborate with a commercial company that is their decision and there is an individual and collective responsibility on all parties to ensure compliance with all legal and ethical requirements.
Opt-in consent is the default requirement under the Health Research Regulations made by the Minister. It is important to note that without those Regulations there would be uncertainty about whether and in what circumstances consent would be required. That uncertainty would be unhelpful for protecting individuals and their health and genetic data. Accordingly, the Regulations provide clarity, certainty and consistency on the range of safeguards that apply when it is intended to collect, use or disclose an individual’s personal data for health research.
Consistent with the approach in other jurisdictions, the Regulations provide for a clearly defined and limited statutory consent declaration process. The process, which emerged after extensive engagement with the Data Protection Commission, enables a data controller proposing to carry out health research using personal data to apply for a consent declaration which means that the consent of the individual is not required for the obtaining and use of his or her personal information for the health research concerned. To be successful, the applicant must be able to demonstrate to the independent Health Research Consent Declaration Committee or Appeal Panel that the public interest in carrying out the health research significantly outweighs the public interest in requiring the explicit consent of the data subject, that it would not be feasible to obtain such consent and that the applicant is willing to ensure a wide range of specified safeguards will be put in place, including carrying out a full Data Protection Impact Assessment, securing ethical approval from a research ethics committee and having a lawful basis for carrying out the research.
As a further safeguard, the Regulations contain an express provision stating that there will be no disclosure of the personal data obtained by a person with a consent declaration unless that disclosure is required by law or the data subject has given his or her explicit consent to the disclosure. That provision is purposely designed to stop data controllers who obtain a consent declaration from revealing, including by way of selling, any personal data they have obtained as a result of the declaration.
I am informed that, in the particular study referred to in the questions, the Health Research Consent Declaration Committee did not approve the application made but the independent Appeal Panel on the basis of the evidence put before it (which included additional evidence) did agree to issue a declaration subject to the a number of strict requirements. In recognising that requiring informed consent on an opt-in basis was not feasible, it took the decision that one of the safeguards should be an opt-out mechanism and it required a publicity campaign to help reach the widest audience.
While I have no role in decisions of independent statutory bodies I did express the view in the Dail last Thursday that an extension should be granted to the opt-out period in light of the exceptional covid-19 circumstances. I am pleased to note that Beaumont have agreed to extend the timeframe by three months until 14 September. Finally, under data protection law, decisions on compliance and matters of enforcement lie with the Data Protection Commission.
695. Deputy Louise O'Reilly asked the Minister for Health if the deal with an organisation (details supplied) for additional testing for Covid-19 protected the samples which were taken from persons; and if the genetic material and data cannot be used for anything other than Covid-19 testing or held for an inordinate length of time. [11478/20]
View answer697. Deputy Louise O'Reilly asked the Minister for Health the health facilities that have transferred genetic material and data to a company (details supplied) to date; and if all patients who had their data transferred consented to this transfer or if it was transferred without their consent and unbeknownst to them. [11480/20]
View answer698. Deputy Louise O'Reilly asked the Minister for Health the terms of the agreement reached with a company (details supplied) for Covid-19 testing; and the way in which the samples and related data are being handled. [11481/20]
View answerI propose to take Questions Nos. 695, 697 and 698 together.
As this is an operational matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
696. Deputy Louise O'Reilly asked the Minister for Health further to Parliamentary Question No. 1129 of 23 July 2019, if the issue of informed consent regarding genetic material and data has been addressed in respect of the transfer of data to a company (details supplied). [11479/20]
View answerThe Data Protection Commission is the statutory body charged with responsibility to ensure protection of data subjects’ rights and compliance by data controllers with data protection law in this country, including the Health Research Regulations.
In line with established international best practice on informed consent in health research, the Regulations require any data controller, in the private or public sector, proposing to process personal data for health research to obtain the explicit consent of the individuals concerned. Explicit consent is informed consent that is recorded and documented.
As with other countries, the Regulations provide for a clearly defined and limited statutory consent declaration process. The process, which emerged after extensive engagement with the Data Protection Commission, enables a data controller proposing to carry out health research using personal data to apply for a consent declaration which means that the consent of the individual is not required for the obtaining and use of his or her personal information for the health research concerned.
To be successful, the applicant must be able to demonstrate to the independent Health Research Consent Declaration Committee or Appeal Panel that the public interest in carrying out the health research significantly outweighs the public interest in requiring the explicit consent of the data subject, that it would not be feasible to obtain such consent and that the applicant is willing to ensure a wide range of specified safeguards will be put in place, including carrying out a full Data Protection Impact Assessment, securing ethical approval from a research ethics committee and having a lawful basis for carrying out the research.
As a further safeguard, the Regulations contain an express provision stating that there will be no disclosure of the personal data obtained by a person with a consent declaration unless that disclosure is required by law or the data subject has given his or her explicit consent to the disclosure. That provision is purposely designed to stop data controllers who obtain a consent declaration from revealing, including by way of selling, any personal data they have obtained as a result of the declaration.
The company referred to in the question is a commercial R&D genomics company. Given the role and responsibilities of the Data Protection Commission it is not for the Minister to assess data protection matters relating to it except to say that the same data protection rules apply to it as apply to other data controllers when it comes to meeting the requirements of the Health Research Regulations.
699. Deputy Louise O'Reilly asked the Minister for Health when the new infection control measures for hospitals will be agreed, published and implemented. [11482/20]
View answerIn order to reduce the risk of transmission of COVID-19 in acute hospitals, the National Public Health Emergency Team mandated the implementation of a suite of 29 measures across a number of different areas including in relation to governance, risk management, outbreak management and staff. My Department is working with the HSE to ensure that these measures are implemented consistently across the acute hospital sector.
The Deputy may wish to note that specific, updated guidance entitled “Acute Hospital Infection Prevention and Control Precautions for Possible or Confirmed COVID-19 in a Pandemic Setting” has been published on the Health Protection Surveillance Centre (HPSC) website. In addition, a general interim outbreak plan for COVID-19 has been developed and published on the HPSC website. I am advised that this plan will be subject to change as the situation evolves.
702. Deputy Mary Butler asked the Minister for Health the position regarding the reopening of podiatry services including face-to-face clinics in University Hospital Waterford; if he will provide a definitive timeline for the reopening of face-to-face services to include potential capacity restrictions for clinics as currently envisaged by his Department; and if he will make a statement on the matter. [11491/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to you directly as soon as possible.
703. Deputy Bernard J. Durkan asked the Minister for Health the extent to which privately insured patients can expect to get ready access to medical procedures; and if he will make a statement on the matter. [11500/20]
View answerA 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.
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.
705. Deputy Thomas Byrne asked the Minister for Health the waiting times for a person to receive home care support hours in County Meath. [11505/20]
View answer706. Deputy Thomas Byrne asked the Minister for Health the number of persons waiting to receive a home care package in County Meath. [11506/20]
View answerI propose to take Questions Nos. 705 and 706 together.
As these are service matters I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
707. Deputy Norma Foley asked the Minister for Health the status of an orthopaedic hospital appointment for a person (details supplied) at Croom Hospital. [11509/20]
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.
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.
708. Deputy Holly Cairns asked the Minister for Health his views on the reopening model introduced by other countries such as France, Italy and China that focused regional variations using registers including the population density of an area and confirmed cases of Covid-19. [11524/20]
View answerThe Government's approach regarding the reduction of measures introduced to control the spread of Covid-19 is public health-led and grounded in evidence, in line with the recommendations of the WHO, the ECDC and the EU Commission, as well as experience and learning from similar countries, both in Europe and further afield including China and elsewhere.
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 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 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 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.
709. Deputy Holly Cairns asked the Minister for Health if he will provide funding for healthcare professionals including carers who cannot access or afford private vehicle transport to purchase bicycles and pedicels to travel to work in view of social distancing requirements and the vulnerability of the patients, clients, and family members they work with. [11525/20]
View answerI have no plans to provide to provide funding for the purchase of bicycles and pedicels to travel to work in the manner described by the Deputy.
However, the Deputy may wish to note that the Health Service Executive (HSE) operates the "Cycle to Work Scheme" a government scheme to encourage people to cycle to work came into force on January 01 2009. Under this scheme, an employer is allowed to incur the expense of providing an employee with a new bicycle and bicycle safety equipment with the employee being liable for benefit-in-kind taxation.
For employees the scheme covers bicycles and accessories up to a maximum cost of €1,000. The HSE purchases the bike and the employee pays the sum back through a salary deduction over a period of up to 12 months. The repayment is made before tax and PRSI are applied.
710. Deputy Holly Cairns asked the Minister for Health the expected timeline for children with special educational needs to be able to attend appointments for speech and language and occupational therapy. [11539/20]
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.
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.
712. Deputy Holly Cairns asked the Minister for Health if he will provide clarification on social distancing guidelines that hotels, restaurants and cafés must follow; and the estimated length of time these restrictions will be in place [11542/20]
View answerWhile the evidence relating to the SARS-CoV-2 virus is evolving, it is clear now that the risks of transmission of any respiratory pathogens such as the type that causes Covid-19 are lessened when greater distance is maintained between people. The current advice is that you should follow social distancing guidance everywhere outside the home, including keeping a physical distance of 2 metres apart. It is also recommended that face coverings be worn in situations where social distancing is difficult to maintain, such as shops, and on public transport, or when meeting someone who is vulnerable to the virus, for example people who are cocooning. The recommendation applies to those people aged over 13 who can tolerate them.
This advice is kept under review by the National Public Health Emergency Team on a continuing basis. Arising from their meeting of 4 June, 2020, the National Public Health Emergency Team has requested that the Health Protection Surveillance Centre develop guidance on the application of existing social distancing requirements in specific, defined and controlled environments in the hospitality industry during periods of low incidence of the disease. This guidance will then be considered by the National Public Health Emergency Team on completion.
The Deputy may also wish to note that on 9 May the “Return to Work Safely Protocol - COVID-19 Specific National Protocol for Employers and Workers” was published. It provides clear guidance to employers and to workers on the measures that must be taken to prevent the spread of COVID-19 in the workplace. The Protocol was developed through the cooperation of the Health and Safety Authority, the Department of Business, Enterprise and Innovation, the HSE and my Department. It is designed to be used by all workplaces to adapt their procedures and practices to provide protection against the threat of COVID-19.
