Tuesday, 23 Jun 2020

Written Answers Nos. 424-443

Covid-19 Pandemic

Questions (424)

Louise O'Reilly

Question:

424. Deputy Louise O'Reilly asked the Minister for Health if a therapeutic residential facility (details supplied) will be reopened to deliver services as soon as possible. [11886/20]

Written answers

Minister of State at the Department of Health (Catherine Byrne)

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

Nursing Home Accommodation

Questions (425)

Louise O'Reilly

Question:

425. Deputy Louise O'Reilly asked the Minister for Health if nursing homes must account for the way in which they spend the €72 million support package; and if so, if a breakdown of the spending will be provided in tabular form, [11887/20]

Written answers

Minister of State at the Department of Health (Jim Daly)

On 04 April, I announced the establishment of a Temporary Assistance Payment Scheme (TAPS) with funding of up to €72.5m available to private and voluntary nursing homes. The Scheme opened for applications on 17 April. The core concept of the scheme is that the State will provide additional funding to those nursing homes that require it, to contribute towards support measures associated with COVID-19 preparedness, mitigation and outbreak management. This temporary scheme will provide support for a 3-month period - April, May and June 2020.

There are two component parts of the Scheme which are integrated:

- a support payment per month based on the number of residents; and

- enhanced assistance in the event of a nursing home actively managing an outbreak.

Under the standard support component, funding may be provided to each applicant nursing home for COVID-19 related measures and associated expected costs for the month. The maximum level of financial support under the Scheme will be calculated by reference to the number of residents in the nursing home at a specified time.

Where a nursing home has incurred significant further costs or undertaken necessary enhanced actions arising directly from a COVID-19 outbreak, a nursing home may submit a separate business case for enhanced assistance.

There is an overall monthly funding cap, which is the maximum amount that may be paid in respect of each month to a Nursing Home under the Scheme. This amount applies to the aggregate of payments under the Standard Assistance Payment and the Outbreak Assistance Payment. It is equal to the lower of:

- twice the Standard Assistance Payment Cap for the month;

- the amount of €75,000.

Where a nursing home applies for an assistance payment through the Scheme, the nursing home may only claim for those additional allowable costs, as set out in the Scheme details. Additional Costs are costs incurred by the Nursing Home which would not have been incurred were it not for the impact of the COVID-19 Pandemic. Allowable Costs are costs that may be included in an application for support under the Scheme. The nursing home must submit a Statement of Additional Allowable Costs in support of an application to the Scheme and, therefore, vouch that all amounts claimed are in relation to those allowable costs arising as a result of the impact of COVID-19.

Applications to the Scheme are made to the National Treatment Purchase Fund (NTPF) in the first instance where an assessment of the application is carried out to determine the payment amount in accordance with the Scheme Rules and subsequently advises the HSE of the proposed payment amount for each Nursing Home. The HSE undertakes a final validation and makes a decision on the application.

The NTPF and/or the HSE will carryout formal audits of claims made retrospectively on a risk and/or sample basis - they will be supported in this work by professional auditors. It will be necessary for the Nursing Home to be able to provide vouched evidence of COVID-19 expenditure as any expenditure that is not vouched will be recoverable.

In some cases, where an outbreak has been experienced and a claim is made under the outbreak assistance component of the Scheme, the claim requires independently certified verification.

I have forwarded the payment aspects of the question to the HSE for direct reply to the Deputy.

Neuro-Rehabilitation Services

Questions (426)

Louise O'Reilly

Question:

426. Deputy Louise O'Reilly asked the Minister for Health if there will be additional investment in neurological services; and if patients suffering from Parkinson’s disease will be provided with biannual access to neurologists. [11889/20]

Written answers

Minister for Health

As the issues raised are service delivery matters, I have asked the Health Service Executive to respond directly to the Deputy.

Hospital Services

Questions (427)

Louise O'Reilly

Question:

427. Deputy Louise O'Reilly asked the Minister for Health if, in cases in which patients are referred by medical professionals for private scans or treatments, they will be notified that they have been referred to a private service (details supplied). [11890/20]

Written answers

Minister for Health

The HSE operates direct access to diagnostics for GP’s. In the case of public services, the HSE pay those fees and no costs arise for either the patient or the GP.

As a matter of good practice and effective communication between GP and patients, I would expect that a GP would discuss the public and private treatment options available to the patient and would inform the patient if they are being referred to a private service and that there will be a cost involved.

Covid-19 Pandemic

Questions (428)

Louise O'Reilly

Question:

428. Deputy Louise O'Reilly asked the Minister for Health the airlines that have been awarded the procurement contracts for the delivery of PPE; and if he will make a statement on the matter. [11891/20]

Written answers

Minister for Health

As the procurement of PPE and other medical equipment is a matter for the HSE, I have asked the agency to reply directly to the Deputy on this matter.

National Children's Hospital

Questions (429)

Louise O'Reilly

Question:

429. Deputy Louise O'Reilly asked the Minister for Health the status of the national children’s hospital; the estimated cost of the project; the estimated completion date; and if he will make a statement on the matter. [11895/20]

Written answers

Minister for Health

The National Paediatric Hospital Development Board (NPHDB) has statutory responsibility for planning, designing, building and equipping the new children's hospital. I have referred your question to the NPHDB for direct reply.

National Maternity Hospital

Questions (430, 431, 432, 433)

Louise O'Reilly

Question:

430. Deputy Louise O'Reilly asked the Minister for Health if the State will own and control the national maternity hospital; and if he will make a statement on the matter. [11896/20]

Louise O'Reilly

Question:

431. Deputy Louise O'Reilly asked the Minister for Health the reason a religious order (details supplied) transferred land at a location for the national maternity hospital to a registered charity and not directly to the State; and if he will make a statement on the matter. [11897/20]

Louise O'Reilly

Question:

432. Deputy Louise O'Reilly asked the Minister for Health if he has received information regarding the structures of a registered charity (details supplied) and the role shareholders will play in the day-to-day operations of the hospitals including the future new national maternity hospital under same. [11898/20]

Louise O'Reilly

Question:

433. Deputy Louise O'Reilly asked the Minister for Health his views on whether the State should own and run the new national maternity hospital; and if so, the reason he has not pursued that option and has instead accepted the ownership and control of the lands on which the hospital will be built by a registered charity (details supplied). [11899/20]

Written answers

Minister for Health

I propose to take Questions Nos. 430 to 433, inclusive, together.

A legal framework is being developed to protect the State's investment in the new National Maternity Hospital (NMH) 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. In that regard, the NMH will provide maternity, gynaecology and neonatal services in the new hospital, whilst the new building will also provide replacement facilities for SVHG e.g a dermatology unit, ward accommodation etc. Some facilities will be shared by the NMH and SVHG including a new staff canteen, a catering kitchen, hospital sterile services department, laboratories etc. The Deputy may wish to note that the legal framework, when finalised, will be brought to Government for approval.

The NMH has a long and proud tradition delivering maternity care to Irish women and I have no reason to see that discontinued, as long as the conditions set out in the proposed legal framework are met. Indeed, I believe that Ireland benefits from having a voluntary sector and that sector should continue to play an integral role in the delivery of health and social care services.

I should clarify that the particular option to develop the new NMH at Elm Park was finalised following an extensive mediation process between the two hospitals, which considered many different options and culminated in the Mulvey Agreement. That agreement represents an accommodation of the views of the two voluntary hospitals together with consideration of key policy objectives, including clinical independence, no religious influences to be brought to bear on the new hospital and assurance that the State's investment will be protected. These overriding objectives will be copperfastened through the legal framework.

As the Deputy will be aware, Mulvey Agreement also sets out the basis for the governance arrangements for the new NMH and 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. I am advised that all of these specific protections will be built into and addressed in the legal framework.

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.

The Religious Sisters of Charity will transfer their shareholding in SVHG to a new company, St Vincent’s Holdings CLG. As the Deputy will appreciate, the Sisters made the decision to transfer their shareholding, and I am not in a position to provide any information as to what informed that decision, or what alternatives were considered. However, I have welcomed the announcement that the Vatican has approved the share transfer, as it removes any remaining concerns that religious influence might be brought to bear on the new hospital.

Finally, the Deputy may wish to note that information in relation to St Vincent’s Holdings CLG is available on the SVHG website and can be accessed through the following address:

https://www.stvincents.ie/app/uploads/2020/05/ST.VINCENTS-HOLDINGS-CLG-Information-Sheet-14.05.2020

Question No. 434 answered with Question No. 392.

Abortion Services Provision

Questions (435)

Jennifer Carroll MacNeill

Question:

435. Deputy Jennifer Carroll MacNeill asked the Minister for Health the changes made to the model of care for termination of pregnancy in the context of the Covid-19 public health emergency; if access to abortion care in early pregnancy has been negatively impacted by the pandemic; and if he will make a statement on the matter. [11910/20]

Written answers

Minister for Health

As part of the Government’s ongoing efforts to protect public health and limit the spread of COVID-19, the Department of Health and the HSE worked together to put new arrangements in place to temporarily allow termination of pregnancy services in early pregnancy to be provided remotely.

For the duration of the COVID-19 public health emergency, where the need for social distancing, reducing personal contacts and reducing the burden on medical practitioners are paramount, it will be possible for a woman to access a termination under section 12 of the Health (Regulation of Termination of Pregnancy) Act 2018 (i.e. before 12 weeks) from her medical practitioner by telephone or video conference consultation.

These new arrangements have been in place since early April to ensure that access to termination of pregnancy services would not be negatively affected by the COVID-19 pandemic. The arrangement enabling remote consultation will lapse once the public health emergency is declared over, and the normal functioning and requirements of the original Model of Care for early pregnancy will resume (i.e., visits to medical practitioners).

Covid-19 Pandemic

Questions (436)

Peadar Tóibín

Question:

436. Deputy Peadar Tóibín asked the Minister for Health if patients were moved to St. Mary's Hospital, Phoenix Park, Dublin, from the long-stay psychiatric accommodation on the grounds of Connolly Hospital, Blanchardstown during the Covid-19 crisis; the number of these patients that lost their lives in March, April, May and June 2020 to date; the category of patients that were moved; the reason they were moved; the location they were moved to; the age and clinical profile of each; the number of patients that died; and the cause of death in each case. [11921/20]

Written answers

Minister of State at the Department of Health (Jim Daly)

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

Home Help Service

Questions (437)

Seán Fleming

Question:

437. Deputy Sean Fleming asked the Minister for Health when home help will be provided to a person (details supplied); and if he will make a statement on the matter. [11937/20]

Written answers

Minister of State at the Department of Health (Jim Daly)

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 (438)

Duncan Smith

Question:

438. Deputy Duncan Smith asked the Minister for Health if an analysis has been undertaken on a comparison between the response of Ireland to the Covid-19 pandemic and other countries in the European Union; and if he will make a statement on the matter. [11938/20]

Written answers

Minister for Health

Ireland is guided in responses to emerging international public health incidents by the advice, guidance and protocols of the World Health Organization (WHO) and the European Centre for Disease Prevention and Control (ECDC) .The expert guidance of the ECDC in particular is based upon consideration of the circumstances arising in the European Union and globally. The National Public Health Emergency Team (NPHET) takes account of these and other international sources as part of its deliberations.

I am in regular contact with my Ministerial counterparts at EPSCO (the Employment, Social Policy, Health and Consumer Affairs) Council meetings where different approaches to the pandemic are discussed. In conjunction with this, the Croatian Presidency of the EU has also activated the Integrated Political Crisis Response to facilitate information sharing among Member States.

The National Public Health Emergency Team (NPHET), chaired by the Chief Medical Officer, has been meeting on a regular basis in relation to the Covid-19 outbreak. An Expert Advisory Group (EAG) provides scientific advice and assistance to the NPHET in carrying out its work. The NPHET, the EAG and officials of my Department continue to monitor the situation relating to COVID-19 including the circumstances arising in other countries. Furthermore, the Chief Medical Officer maintains regular contact with colleagues in Britain and Northern Ireland.

While analysis comparing the situation in Ireland with other countries is useful, considerable caution must be exercised in doing so. Circumstances such as, for example, the socio-economic status of the population, population density, age profile, rates of underlying conditions, date of first reported cases, varying data collection methodologies and reporting arrangements, testing strategies etc are often not directly comparable or are very challenging to analyse in a manner that can be directly comparable.

Notwithstanding some limitations in international comparisons, particularly at this point in time, a considerable amount of work has been undertaken to analyse and learn from international experiences. The NPHET Covid-19 Subgroup on Guidance and Evidence Synthesis was established to facilitate information exchange on the public health and clinical guidance relating to the disease. The subgroup is monitoring international efforts on an ongoing basis. Further information is available at https://www.gov.ie/en/collection/07d750-nphet-covid-19-subgroup-guidance-and-evidence-synthesis/.

The NPHET also recently published a Comparison of Mortality Rates between Ireland and other countries in EU and Internationally. The report, which is available at https://www.gov.ie/en/publication/84bc5-covid-19-comparison-of-mortality-rates-between-ireland-and-other-countries-in-eu-and-internationally/ reviews COVID-19 mortality in Ireland in comparison with a number of comparable health systems and reviews possible factors which have contributed to Irish mortality experience to date.

The report also describes a number of the factors affecting mortality which make direct comparisons between countries difficult. For example, the Deputy might wish to note that, in Ireland, data are collected on COVID-19 related mortality for both lab confirmed and probable cases, in line with recommendations from the European Centre for Disease Prevention and Control in both hospitals and the community. We committed from the outset to collect the most extensive data possible in order that the information could inform and guide the public health actions necessary to respond to the very serious threat posed by COVID-19. The Deputy might note that the collection of mortality data in Ireland exceeds that of many other countries in the world.

The NPHET and my Department will continue to consider all available evidence and the experience and learning from other countries as we try to keep the level of transmission of the virus as low as possible while also balancing the continuing restrictions proportionately with the social and economic benefits arising from the easing of restrictions in the coming period.

Covid-19 Pandemic

Questions (439, 503)

Patrick Costello

Question:

439. Deputy Patrick Costello asked the Minister for Health if he will provide information on regulations regarding the use of facemasks; his plans to make them mandatory on public transport and in taxis; and his views on whether they should be distributed to households. [11953/20]

Joan Collins

Question:

503. Deputy Joan Collins asked the Minister for Health if he will make it mandatory to wear facemasks on public transport and indoors (details supplied). [12306/20]

Written answers

Minister for Health

I propose to take Questions Nos. 439 and 503 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 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 a two-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.

It is important to emphasise 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. Face coverings should be used properly, in line with the guidance and to wash hands before putting them on and taking them off.

NPHET, at its meeting on Thursday 11 June, recommended that the focus in the first instance should be on increasing compliance with the current recommendations on the use of face-coverings, through the development and implementation of a national communications campaign.

On the 15th June, the Government and the National Transport Authority launched a national communications campaign which outlines best practice for the use of face coverings in retail outlets, on public transport and in other public locations in which it is difficult to maintain social distancing or where this distance cannot be guaranteed, and will communicate to the public about:

- who should wear face coverings

- in what settings, and

- how to wear and remove face coverings correctly.

Guidance on how to make and safely use face coverings is available on gov.ie/facecoverings and the HSE website.

The NPHET keeps the position on the wearing of face coverings under continual review.

General Practitioner Services

Questions (440)

Paul Murphy

Question:

440. Deputy Paul Murphy asked the Minister for Health if he will call for the general practitioner card to be made available to all persons who are deemed eligible for the respite care grant as certified by their respective general practitioners; and if he will make a statement on the matter. [11961/20]

Written answers

Minister for Health

Since 1 September 2018 all those in receipt of either a full or half-rate Carer's Allowance or Carer's Benefit are automatically eligible for a GP visit card. It is noted that many persons in receipt of the Carer's Support Grant will qualify for a GP visit card as the Carer's Support Grant is paid automatically to persons in receipt of Carer's Allowance or Carer's Benefit.

Question No. 441 answered with Question No. 392.

Mental Health Services

Questions (442)

Michael Moynihan

Question:

442. Deputy Michael Moynihan asked the Minister for Health his plans to establish specialist mental health and deafness services such as those in place in many other countries such as the USA and the UK; and if he will make a statement on the matter. [11990/20]

Written answers

Minister of State at the Department of Health (Jim Daly)

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

Air Ambulance Service

Questions (443, 541)

Michael Moynihan

Question:

443. Deputy Michael Moynihan asked the Minister for Health if his Department has evaluated that financial support that can be provided for an air ambulance; if his Department is actively working on ways in which it can ensure the long-term viability of this vital service; and if he will make a statement on the matter. [11991/20]

Louise O'Reilly

Question:

541. Deputy Louise O'Reilly asked the Minister for Health if funding will be provided to an air ambulance service (details supplied); and if he will make a statement on the matter. [12493/20]

Written answers

Minister for Health

I propose to take Questions Nos. 443 and 541 together.

The Helicopter Emergency Medical Service (HEMS) provided by Irish Community Rapid Response (ICRR) is underpinned by a Service Level Agreement (SLA) with the HSE. This SLA was agreed by ICRR and the HSE on the basis of a charitably funded partnership arrangement, whereby ICRR fund the aircraft and pilot, and the National Ambulance Service (NAS) provides clinical staff, equipment and consumables.

It was never envisaged that Government funding would be required, or would be available, to subvent ICRR, and the decision to proceed with the service arrangement was contingent on the contribution of the charity to the cost of the operation of the service. Any decision to provide exchequer funding would thus be dependent on detailed consideration by the NAS/HSE and the Department of Health of the service need and potential costs. Such a decision would also be subject to public procurement rules.

ICRR and the NAS have been working collaboratively to examine all options to protect the service within the terms of the SLA, including in relation to difficulties in continuing the service in the context of COVID-19.

I am pleased to advise the Deputy that ICRR has recently informed the NAS that, following an internal review of costings, ICRR Air Ambulance has recommenced a seven-day service from the 1st June 2020.