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Tuesday, 23 Jun 2020

Written Answers Nos. 404-423

Alcohol Treatment Services

Questions (404)

Seán Crowe

Question:

404. Deputy Seán Crowe asked the Minister for Health if his attention has been drawn to the concerns of organisations dealing with and supporting those with alcohol addiction issues regarding the impact of the Covid-19 lockdown on mental health and the difficulties in holding one-to-one and group supports at present; and if there has been a new assessment regarding holding of such meetings, which many are of the view are essential for their health and well-being. [11654/20]

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Written answers

The Covid-19 pandemic has created a time of uncertainty and anxiety for everyone and particularly for those who are affected by drug and alcohol addiction. The restructuring of services, social distancing measures and self-isolation can be particularly difficult for those who are trying to remain drug or alcohol free and for those who are in recovery.

Officials in the Department of Health have been working with Drug and Alcohol Task Forces and the HSE Social Inclusion Services to ensure that services and supports continue to be provided for those with problem drug and alcohol use, in line with public health advice. Details of services operating during the coronavirus outbreak can be found at 'drugs.ie'.

The HSE has advised that some support groups may be available online. AA have responded to the crisis by providing online support groups and several other groups including NA and SMART Recovery are also providing online support. In addition, the HSE Drug and Alcohol Helpline is available from Mon-Fri. 9.30-5.30pm 1800 459 459.

The Department and the HSE have produced a poster to provide advice on reducing harm for people dependent on alcohol or in treatment. The poster contains a number of key messages aimed at reducing the harms associated with alcohol and providing advice and supports for recovery.

Mental Health services have responded to the crisis by also providing group and family meetings via video links. Drugs.ie contains information about dual diagnosis and advice for looking after your mental health during the COVID-19 outbreak. There is a Drug Recovery Page on drugs.ie which gives advice to people who are attempting to remain abstinent and also provides links to a number of relevant support services.

Work is currently underway to prepare for the reintroduction of drug and alcohol services in a planned and appropriate manner in line with public health recommendations. This includes guidance on one-to-one and group supports.

I am very much aware of the difficulties for people with drug and alcohol dependency at this time. I would advise people to keep in touch with addiction services and support groups to find out the services that are currently available.

Misuse of Drugs

Questions (405)

Seán Crowe

Question:

405. Deputy Seán Crowe asked the Minister for Health the strategy being developed by his Department and other organisations in conjunction with parents and others to discourage the usage of nitrous oxide (details supplied) in view of the widespread availability among young users. [11655/20]

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Written answers

The Government is committed to a health-led approach to drug use, as set out in the national drugs strategy Reducing Harm, Supporting Recovery, a health-led response to drug and alcohol use in Ireland 2017-2025.

One of the objectives of the strategy is to prevent the use of drugs and alcohol at a young age. Raising awareness of the risks of substance use and increasing understanding of the harmful effects on health and wellbeing is an important part of prevention.

The Department of Health works with the HSE, the Department of Education and Skills and drug and alcohol task forces to raise awareness of the dangers associated with substance misuse and to promote health and wellbeing.

The US National Institute of Drug Abuse considers nitrous oxide as an inhalant which includes solvents, aerosols and gases found in household products. It is also an anaesthetic used by dentists and medical professionals to sedate patients undergoing minor medical procedures.

The selling of Nitrous Oxide canisters for human consumption is an offence Contrary to Section 3 of the Psychotic Substance Act 2010.

The HSE Drugs.ie website provides a comprehensive range of information and supports related to substance use. Nitrous oxide has been previously highlighted by the HSE as an emerging issue. It warned young people about the danger of using nitrous oxide through a media release in January. New content has been added to Drugs.ie outlining the effects and risks associated with nitrous oxide.

Parents play an important role in educating young people on the risks regarding substance abuse. Evidence based content is available on Drugs.ie regarding nitrous oxide, as well as a HSE booklet providing advice for parents on how to talk to young people about the risks associated with drug and alcohol use.

Recently, the HSE launched Know the Score, the first national evidence-based resource on alcohol and drugs for senior cycle students. It aims to engage young people in exploring and considering a wide range of topics related to the risks associated with alcohol and drugs.The Department of Health, as part of the introduction of the Health Diversion Programme, is providing €100,000 in 2020 to the HSE for the development of a national harm reduction campaign to raise awareness of the risks associated with drug use. This will include the use of club drugs, festival drug use and new trends. While this campaign was originally scheduled for the latter part of 2020, this timetable may need to be revised given the draw on resources in dealing with Covid 19.

We must be vigilant in protecting young people from the dangers of substance misuse, including nitrous oxide. I believe a multi-faceted approach, involving online resources, in-school interventions and targeted awareness campaigns, can best promote the health and wellbeing of young people.

Hospital Appointments Status

Questions (406)

Éamon Ó Cuív

Question:

406. Deputy Éamon Ó Cuív asked the Minister for Health when a date for surgery in respect of a spinal operation will be issued to a person (details supplied); the reason for the multiple cancellations of dates issued for the surgery over the last number of years; if he will take into account that the person is on a high-risk list; and if he will make a statement on the matter. [11673/20]

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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 Data

Questions (407)

Louise O'Reilly

Question:

407. Deputy Louise O'Reilly asked the Minister for Health further to Parliamentary Question No. 752 of 3 June 2020, if the 11,907 beds referenced are all in the public and voluntary hospital system; and the hospitals that these beds are in, in tabular form. [11675/20]

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Written answers

I regret that I have been advised by the HSE that due to an error the figure of 11,907 which was previously provided should have read 11,597. I confirm that the figure of 11,597 beds includes capacity in public and voluntary hospitals only, excluding critical care beds and day beds. This includes 324 beds funded in March 2020 in response to the Covid 19 pandemic, some of which are located off the acute hospital campus.

It should be noted that this is the total current bed capacity. However beds are unavailable when they are temporarily closed for reasons such as infection control, maintenance/refurbishment, or staffing shortages.

With regard to the Deputy's request of a breakdown by site, I have asked the HSE to respond to the Deputy directly.

Drug and Alcohol Task Forces

Questions (408)

Gerald Nash

Question:

408. Deputy Ged Nash asked the Minister for Health the funding provided to each regional and local drugs task force in each of the years 2016 to 2020, in tabular form; and if he will make a statement on the matter. [11699/20]

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Written answers

The National Drugs Strategy Reducing Harm, Supporting Recovery is a health-led response to the problem of drug and alcohol use in Ireland. The strategy is underpinned by a partnership approach between the statutory, non-statutory and community and voluntary sectors.

Drug and Alcohol Task Forces play a key role in assessing the extent and nature of the drug problem in local communities. They ensure that a coordinated approach is taken across all sectors to address substance misuse based on the identified needs and priorities in their areas.

The Department of Health and the HSE provide total annual funding of €28m to Drug and Alcohol Task Forces for local initiatives to tackle drug and alcohol use and misuse, in line with the national drugs strategy. Task Forces use this funding to support over 280 community projects throughout the country.

Additional funding of €1m was provided for the implementation of the National Drugs Strategy in 2019. €480,000 of this funding provided an additional €20,000 for each of the 24 Task Forces. €10,000 of this funding will be on a permanent recurring basis. The 2020 allocation for Drug and Alcohol Task Forces includes an additional €10,000 in the core funding of each Task Force, arising from the additional funding provided in 2019.

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Dental Services

Questions (409)

Éamon Ó Cuív

Question:

409. Deputy Éamon Ó Cuív asked the Minister for Health when a date for surgery in respect of teeth extraction will be issued to a person (details supplied); if he will take into account the exceptional circumstances in this case; and if he will make a statement on the matter. [11700/20]

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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.

Dental Services

Questions (410)

Cathal Crowe

Question:

410. Deputy Cathal Crowe asked the Minister for Health if he will examine the issue of long-term waits for orthodontic treatment in view of the negative mental and physical health impacts on young persons that are in the higher stages of orthodontic needs [11705/20]

View answer

Written answers

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

Health Screening Programmes

Questions (411)

Michael Fitzmaurice

Question:

411. Deputy Michael Fitzmaurice asked the Minister for Health when CervicalCheck and BreastCheck will resume; the way in which the health service plans to catch up on missed screening; and if he will make a statement on the matter. [11714/20]

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Written answers

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

HSE Staff

Questions (412)

Frank Feighan

Question:

412. Deputy Frankie Feighan asked the Minister for Health his plans to introduce a new voluntary early retirement scheme to encourage HSE Civil Service staff nearing 40 years of employment to retire from service early but with full 40-year entitlements; and if he will make a statement on the matter. [11728/20]

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Written answers

I have no plans at this time to introduce a voluntary early retirement scheme for HSE employees.

Mental Health Services

Questions (413)

Mark Ward

Question:

413. Deputy Mark Ward asked the Minister for Health if a comprehensive report on the purpose for which funding is being used by an organisation (details supplied) will be provided; and if he will make a statement on the matter. [11734/20]

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Written answers

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

Covid-19 Pandemic

Questions (414)

Neasa Hourigan

Question:

414. Deputy Neasa Hourigan asked the Minister for Health his views on a hospital (details supplied) failing to give its nurses the same sick leave entitlements as those in the public service in which Covid-19 sick leave is not deducted from the normal sick leave record of a person; and if he will make a statement on the matter. [11761/20]

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Written answers

Guidance has been provided by the Department of Public Expenditure and Reform (DPER) to assist Public Service Employers in relation to working arrangements and leave associated with COVID-19. These guidelines cover all possible situations for all public sector employees.

A copy of this document is available to view at this link for your information. https://www.gov.ie/en/news/d2536d-covid-19-faqs-for-hr-in-the-civil-and-public-service/

As the hospital the Deputy is referring to is a private employer, its employee terms and conditions are outside of my remit.

National Maternity Hospital

Questions (415)

Duncan Smith

Question:

415. Deputy Duncan Smith asked the Minister for Health if information will be provided regarding the ownership of the national maternity hospital when it moves to the grounds of St. Vincent’s hospital; and the person or body that will control the running of the hospital. [11770/20]

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Written answers

A legal framework is currently being developed to protect the State's investment in the new maternity hospital at Elm Park and to ensure that the hospital remains in State ownership; it is envisaged that the State will provide an Operating Licence to the NMH at Elm Park DAC and the St Vincent's Healthcare Group (SVHG) to facilitate the provision of health services in the new building. The Deputy may wish to note that the legal agreement, when finalised, will be brought to Government for approval.

The governance arrangements for the new NMH will be based on the provisions of the Mulvey Agreement. That Agreement provides for the establishment of a new company - National Maternity Hospital at Elm Park DAC - which will have clinical and operational, as well as financial and budgetary independence in the provision of maternity, gynaecology and neonatal services. The Agreement ensures that a full range of health services will be available at the new hospital without religious, ethnic or other distinction.

In line with the Mulvey Agreement, the Board of the NMH at Elm Park DAC will comprise 9 directors; 4 nominated by SVHG, 4 by NMH, and 1 will be an international expert in obstetrics and gynaecology. Given the level of State investment, I have sought, and received, the agreement of both the NMH and SVHG that the Board of the new NMH DAC will be competency-based and will include a Public Interest representative.

Medicinal Products

Questions (416, 459, 532)

Michael Moynihan

Question:

416. Deputy Michael Moynihan asked the Minister for Health the status of a decision on the reimbursement for the drug osimertinib for treatment of advanced lung cancer; and if he will make a statement on the matter. [11773/20]

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Thomas Byrne

Question:

459. Deputy Thomas Byrne asked the Minister for Health the status of the reimbursement of osimertinib. [12087/20]

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Darren O'Rourke

Question:

532. Deputy Darren O'Rourke asked the Minister for Health when Tagrisso will be available to patients under the general medical scheme; and if he will make a statement on the matter. [12457/20]

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Written answers

I propose to take Questions Nos. 416, 459 and 532 together.

The HSE has statutory responsibility for medicine pricing and reimbursement decisions, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013. The Act specifies the criteria to be applied in the making of reimbursement decisions which include the clinical and cost effectiveness of the product, the opportunity cost and the impact on resources that are available to the HSE.

I can advise the Deputy that the HSE has approved the application for reimbursement of Osimertinib (Tagrisso) for non small cell lung cancer, the specific recommendation is for second-line use for the treatment of adult patients with locally advanced or metastatic EGFR T790M mutation-positive non small cell lung cancer.

Reimbursement will commence from 1 July 2020.

Dental Services

Questions (417, 556, 565)

Robert Troy

Question:

417. Deputy Robert Troy asked the Minister for Health if his attention has been drawn to the fact that some dental practices are advising patients that they are implementing an additional charge in order to cover the cost of personal protective equipment and that some practices are charging patients €18 per visit to cover this cost; and if officials from his Department have raised this matter with an organisation (details supplied). [11786/20]

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Pa Daly

Question:

556. Deputy Pa Daly asked the Minister for Health the details of PPE being provided to dental practices nationally; the criteria relative to prioritisation; and the timeline under which PPE will be provided. [12582/20]

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Ruairí Ó Murchú

Question:

565. Deputy Ruairí Ó Murchú asked the Minister for Health if his attention has been drawn to the fact that some dentists have informed medical card patients that they are no longer accepting medical cards as a form of payment due to increased costs associated with PPE and social distancing measures; the rate of payments being made to dentists to treat medical card patients; and if he will make a statement on the matter. [12615/20]

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Written answers

I propose to take Questions Nos. 417, 556 and 565 together.

The Dental Treatment Services Scheme (DTSS) provides dental care free of charge to medical card holders aged 16 and over. These services are provided by independent dental practitioners who have a contract with the HSE. Fees paid to dentists under the DTSS are set out in the Health Professionals (Reduction of Payments to Registered Dentists) Regulations 2009 and the Health Professionals (Reduction of Payments to Registered Dentists) Regulations 2012.

I am concerned to hear of instances of medical card holders being refused access to treatment. I would hope that dentists would feel obliged to honour their ethical and contractual obligations to patients, to either provide a service or to refer patients to a neighbouring dentist who will provide a service.

I would also expect that due process is followed in respect of any withdrawal from the terms of a DTSS contract, in particular with regard to an appropriate period of notice.

The cost of PPE should not be a key determinant in decisions on the treatment of patients, as the Health Protection Surveillance Centre has advised that regular PPE, which has always been used, is generally sufficient for routine dentistry. This is supported by the Dental Council which has indicated that dentists should take a case by case assessment when deciding if additional PPE is warranted.

My Department, in conjunction with the HSE, is examining the issue of the provision of PPE across all parts of the health service, including health service contractors.

A review of the provision of dental services for those eligible for public services is required in the context of the implementation of the National Oral Health Policy, Smile agus Sláinte, and the issue of fees will be considered in that context.

In relation to social distancing costs, 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.

My Department has no role in the setting of fees charged by independent dentists to their private patients. The Dental Council has a Code of Practice relating to the display of private fees in dental practices.

Abortion Services Provision

Questions (418)

Carol Nolan

Question:

418. Deputy Carol Nolan asked the Minister for Health the membership and terms of reference of the clinical advisory forum that was established to provide guidance on termination of pregnancy services; the number of times the forum has met; and if he will make a statement on the matter. [11812/20]

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Written answers

As the deputy's question refers to a service matter, I have referred it to the HSE.

General Practitioner Services

Questions (419)

Carol Nolan

Question:

419. Deputy Carol Nolan asked the Minister for Health the details of the payments issued to date to the 352 general practitioners providing termination of pregnancy services within the HSE; and if he will make a statement on the matter. [11814/20]

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Written answers

Under Section 20(3) of the Health (Regulation of Termination of Pregnancy) Act 2018, the Minister for Health is required to prepare a report on the notifications of terminations of pregnancy received during the immediately preceding year, and lay it before the Houses of the Oireachtas not later than 30 June. Therefore, the first such report will be laid before the Houses of the Oireachtas by end-June 2020. I believe that in the light of this statutory requirement, it would not be appropriate to pre-empt the annual report by publishing data, the effect of which would be to place in the public domain information of a type intended by the Oireachtas to be addressed in the annual report.

Departmental Policy Functions

Questions (420)

Carol Nolan

Question:

420. Deputy Carol Nolan asked the Minister for Health if his Department has a diversity and inclusion policy in place; the measures taken to promote diversity and inclusion from 1 January 2019 to date; and if he will make a statement on the matter. [11827/20]

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Written answers

My Department is fully committed to creating a workplace and to delivering services that are completely free of discrimination of any kind and which uphold the principles of equality, diversity and inclusion.

The Civil Service Code of Standards and Behaviour, the Civil Service Dignity at Work Policy and the Civil Service Code of Practice for the Employment of People with Disabilities apply to the staff of the Department of Health. In line with these policies, every member of staff has been made aware of their duty to behave in an acceptable and respectful manner and of their responsibility to create a working environment in which differences are respected and in which all staff can be their authentic selves.

The staff of the Department are recruited through the Public Appointments Service which is actively responding to changes in Irish society to reflect the communities we serve and is strongly committed to equality of opportunity in all its employment practices.

The Department has a dedicated Disability Liaison Officer who promotes awareness of disability and the needs of people with disabilities among staff, who supports and assists staff with a disability and who reports annually to the Department of Public Expenditure and Reform on the employment of people with disabilities.

Diversity and inclusion information is regularly shared on the Department’s staff intranet, for example highlighting International Women’s Day, International Men’s Day, International Day for People with Disabilities and LGBTQ Pride events.

The Department has a Gender Balance Action Plan which aims to improve the balance of women in the Department, in particular at senior levels.

Some specific actions undertaken in the Department since 1 January 2019 to promote diversity and inclusion include:

- The Department’s Statement of Our Values and Behaviours was developed in collaboration with staff in the Department and aims to promote standardised behaviours that have the potential to positively impact interpersonal relationships and foster a collaborative working environment.

- Staff of the Department participated in the 2019 Dublin Pride parade.

- A lunch and learn session for all staff was held to commemorate International Men’s Day.

- Unconscious Bias Workshops have been provided to staff.

- The Department has participated in the WAM (Willing, Able, Mentoring) and Job Shadow initiatives by providing work placements to people with disabilities.

- The Department participated in the ‘North East Inner City’ Transition Year (TY) Placement Programme in February 2020. Eight TY students (two with visual impairments) joined the Department for one week’s work experience.

- One-to-one executive coaching is available to female senior managers returning to work following maternity leave, to support their transition back into the workforce and work-sharing has been facilitated for staff at senior level.

Covid-19 Pandemic

Questions (421)

Peadar Tóibín

Question:

421. Deputy Peadar Tóibín asked the Minister for Health the location of each facility that was procured by his Department, the HSE or another State organisation in 2020 for Covid-19-related purposes; the size of each in terms of area and rooms; the length of each contract; the cost of each; the purpose of each; and the volume of use that it has had in each month of 2020 to date [11857/20]

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Written answers

My Department has not procured any facility for Covid-19 related purposes. Procurement of facilities by other State organisations other than in the health services are matters for the relevant Minister with responsibility for that organisation.

In relation to facilities that have been procured by the Health Service Executive, as this is an operational matter, I have asked the HSE to respond directly to the Deputy as soon as possible.

Neuro-Rehabilitation Services

Questions (422)

Joe O'Brien

Question:

422. Deputy Joe O'Brien asked the Minister for Health the staffing levels nationally in terms of health specialists focused on the treatment of Parkinson’s disease; and his plans to expand access to neurologists, more nurse specialists and referrals of all patients to services such as physiotherapy, speech therapy, occupational therapy and dietetics. [11862/20]

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Written answers

As the issue raised is a service delivery matter, I have asked the Health Service Executive to respond directly to the Deputy.

Health Services

Questions (423)

Louise O'Reilly

Question:

423. Deputy Louise O'Reilly asked the Minister for Health the status of the provision of universal access to contraception; if a decision has been made on the three policy approaches identified by the Working Group on Access to Contraception in its report; his plans to implement the policy; the timeframe for development and roll-out of a contraception scheme; and if he will make a statement on the matter. [11882/20]

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Written answers

I am committed to expanding access to contraception and moving toward the provision of a free contraception service. At this time, no decision has been taken on the parameters of any scheme. A number of regulatory, legal and policy issues must still be addressed, while further consultation with potential providers will also be required.

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