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Tuesday, 23 Jun 2020

Written Answers Nos. 504-523

Hospital Appointments Status

Questions (505)

Pádraig O'Sullivan

Question:

505. Deputy Pádraig O'Sullivan asked the Minister for Health when a person (details supplied) will receive an appointment; and if he will make a statement on the matter. [12311/20]

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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.

Medical Cards

Questions (506)

Peter Burke

Question:

506. Deputy Peter Burke asked the Minister for Health when changes to the medical card eligibility criteria will be implemented to enact the policy change regarding income thresholds for persons over 70 years of age as announced in budget 2020; and if he will make a statement on the matter. [12319/20]

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Written answers

On 16 December 2019, the Government approved the drafting of legislation which, inter alia, would give effect to the Budget 2020 commitment to increase the medical card income thresholds for persons aged over 70. Substantial work has been undertaken by officials in this regard.

Hospital Equipment

Questions (507)

Thomas Pringle

Question:

507. Deputy Thomas Pringle asked the Minister for Health his plans to ensure that PPE that has been lost in the recent fire in Letterkenny, County Donegal, will be replaced by his Department and that Letterkenny University Hospital will not be left without it at this time; and if he will make a statement on the matter. [12350/20]

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Written answers

The HSE took immediate action to ensure that there was no interruption to supplies of PPE and other equipment to Letterkenny University Hospital following the fire at a business premises in Letterkenny last Monday, 15 June. A temporary storage facility was established at Letterkenny University Hospital the following day, and equipment stocks were replenished with supplies from Sligo and Tullamore. The HSE has confirmed that there has been no adverse impact on supply to either Donegal Community Services or Letterkenny University Hospital.

Covid-19 Pandemic

Questions (508)

David Cullinane

Question:

508. Deputy David Cullinane asked the Minister for Health the latest plans in place for the reopening of day services for persons with disabilities; if there is a timeline for the reopening of these services; if so, the timeline; and if he will make a statement on the matter. [12351/20]

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Written answers

As part of the overall effort to contain the spread of COVID-19 and in line with public health advice, day service locations have been closed since March. However priority service users have been identified in each CHO, and individualised supports continue to be provided to many people in alternative models particularly for these individuals with higher support needs, through alternative means such as via online support and/or regular telephone contact with families. Health and social care responses to the current public health emergency are under continuing review, including specific measures such as these to support vulnerable people.

The resumption of adult day services is currently being considered by my Department and the HSE as part of broader planning to prepare for the resumption of non-COVID-19 community and social care services in the current environment, and in line with public health guidance. My Department and the HSE has established a Joint Working Group to develop a plan for Community Capacity.

The HSE is finalising plans to re-establish vital non-COVID supports and services. This includes very careful and detailed work on the part of the disability sector with national guidance and will result in directing how all funded agencies can deliver services on a medium to long-term basis. A national group for the resumption of day services representative of service users and families, service providers and the HSE is working together to prepare for the resumption of day service supports in line with COVID-19 guidance. The Framework for the Resumption of Adult Disability Day Services and Action Plan for resumption of services have been completed. The national group are currently developing guidance to support the day service sector to reopen within the parameters of public health advice.

Community Healthcare Organisations are working with service providers to ascertain the current level of service provision and innovative practises that have developed over the last number of months. The collation and analysis of this data will provide a current national picture which will enable the resumption group to address the challenges of reopening day service locations.

The resumption group plan to have completed the above strands of work by the end of June following which a timeframe for the phased reopening of adult day services will be planned in cooperation with HSE disability services and service providers. In the meantime, service providers continue to contact day service users regarding their support needs and are providing those supports in different ways. Some supports continue to be provided in a number of ways, for example by telephone, online communication and responses to address emergency needs.

The HSE and disability service providers, where identified, will continue to communicate with school leavers and their families to plan and organise for a transition to day services in line with public health guidance.

The safety of service users and staff is of critical importance therefore the attendance at locations will be determined by public health guidance, which may result in some reduction of capacity.

An information leaflet for service users and their families was developed by the national group and distributed widely to all stakeholders on June 9th.

It is expected that a clearer picture will emerge before end of June as to when day services are likely to be reinstated and how the service will be delivered taking account of Public Health Guidance and COVID-19 restrictions.

The Framework for Resumption of Adult Disability Day Services and the information leaflet “What’s Happening” is available on the New Directions website: www.hse.ie/newdirections.

Mental Health Services

Questions (509)

Martin Browne

Question:

509. Deputy Martin Browne asked the Minister for Health the plans in place to address the issues of dual diagnosis in mental health services (details supplied); and his views on plans to address the lack of dual diagnoses within HSE services. [12365/20]

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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.

Mental Health Services

Questions (510)

Martin Browne

Question:

510. Deputy Martin Browne asked the Minister for Health if a mental health unit in Clonmel, County Tipperary, will reopen as a dedicated mental health unit for the region; and if not, if another suitable mental health unit will be provided for Tipperary if the HSE proceed with plans to use the refurbished unit as an acute inpatient service. [12366/20]

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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.

Maternity Services

Questions (511)

Seán Haughey

Question:

511. Deputy Seán Haughey asked the Minister for Health when restrictions on fathers visiting their partners giving birth in maternity hospitals will be lifted; and if he will make a statement on the matter. [12373/20]

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Written answers

As this is a service issue, I have asked the Health Service Executive to reply to you directly.

Medical Aids and Appliances

Questions (512)

Pauline Tully

Question:

512. Deputy Pauline Tully asked the Minister for Health the reason for refusing to purchase a CPAP machine for the treatment of sleep apnoea, which costs approximately €800 on the drugs repayment scheme; the reason the same machine is being rented at a cost of around €80 per month, which will ultimately prove a more expensive option in the medium to long term; and if he will make a statement on the matter. [12386/20]

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Written answers

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

Data Protection

Questions (513)

Róisín Shortall

Question:

513. Deputy Róisín Shortall asked the Minister for Health the number of patients whose genomic data have been shared with a company (details supplied) without consent; when data subject access requests to Irish hospital groups regarding this matter will be processed; and the reason they have not been processed within the statutory one-month time limit. [12389/20]

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Written answers

As these are service matters, I have asked the Health Service Executive to respond to you directly, as soon as possible.

HSE Reviews

Questions (514)

Róisín Shortall

Question:

514. Deputy Róisín Shortall asked the Minister for Health if the review of the processes in the clinical genetics department of Our Lady’s Children’s Hospital, Crumlin is completed; the reason a company (details supplied) remained in procession of the DNA samples during the review; and if he will make a statement on the matter. [12390/20]

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Written answers

As these are service matters, I have asked the Health Service Executive to respond to you directly, as soon as possible.

Health Research Board

Questions (515)

Róisín Shortall

Question:

515. Deputy Róisín Shortall asked the Minister for Health if he is considering amending the health research regulations with regard to emergency care intervention; if a provision to auto-enrol persons who arrive to hospital in an unconscious state is being considered; and if so, if the patients next of kin could withdraw consent [12391/20]

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Written answers

The Health Research Regulations are made under the Data Protection Act 2018. Accordingly, they deal only with the processing of personal data for health research purposes and cannot affect the law relating to emergency care interventions which is a matter for the treating clinicians. I am not considering amending the law in that area as clinicians need to be free to provide the best clinical care that they can to patients, including in emergency care situations

Research into innovative interventions in emergency care can be critical to patient survival. Such research plays an important role in obtaining knowledge for improvement in therapy, patient safety and progress in medicine. Future patients will benefit from critical care research results of today. If, in the assessment of efficacy and safety of new emergency care interventions, data is only included on less-severely affected patients, this results in a selection bias, jeopardises the balance between study arms and reduces the overall validity of the research. This renders emergency care research almost impossible and incapable of assessing how interventions may differ in patients who die early than in survivors or those who die later.

Most countries worldwide have introduced regulatory mechanisms and/or guidance to enable emergency care research, and practices vary from waivers of consent to proxy consent to deferred consent for the inclusion of patients who lack capacity to consent to their data being used for research purposes in emergency care situations.

For interventions involving medicinal products, there is provision under the Clinical Trials on Medicinal Products for Human Use Regulations 2004 (S.I.190 of 2004) (as amended) to provide for a patient to be enrolled in a clinical trial of a medicinal product that has been approved by a recognised research ethics committee where the patient lacks capacity to consent, for example in an emergency care situation, subject to the approval of the patient’s legal representative. That term is defined in the 2004 Regulations as including a person, other than a person connected with the conduct of the trial, who by virtue of his or her or her family relationship with that adult, is suitable to act as the legal representative for the purposes of that trial and is available and willing to act for those purposes. Further, from a legal and ethical perspective, the inclusion of any person in a clinical trial must always be on a clinically sound basis.

What I have been considering in relation to individuals who lack capacity to consent in emergency care situations is the following limited, qualified and specific amendment to the Health Research Regulations. In exceptional circumstances, where the principal purpose of the processing or further processing of the personal data by a controller is necessary for the provision of health care to an individual and necessary to protect the vital interests of the individual, and where the individual is, by reason of his or her physical or mental incapacity, incapable of giving consent at that time, the personal data may also be processed by that controller for a related health research purpose, where that health research has been approved by a research ethics committee. In those circumstances, the requirement for explicit consent under the Health Research Regulation is not removed or waived but deferred until such time as the individual concerned has the capacity to give or refuse such consent. This amendment, brings emergency care research in Ireland in line with the prevailing ethical and regulatory practices internationally, provides consistency and clarity for all involved. It most definitely does not provide for auto enrolment in a research study.

Health Research Board

Questions (516)

Róisín Shortall

Question:

516. Deputy Róisín Shortall asked the Minister for Health the legal basis for processing DNA for research, particularly when access to the data will be determined by a commercial entity without robust public engagement. [12392/20]

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Written answers

It is the General Data Protection Regulation (GDPR) rather than domestic law that sets out the legal basis for the processing of any personal data, including for research purposes, and domestic law cannot amend the GDPR legal basis. Where health or genetic data is involved, the data controller concerned, whether it is a public authority or a commercial entity, must have a basis in Article 6 and meet a condition in Article 9. The data controller must also comply with the other requirements in the GDPR, in particular the principles in Article 5, and have suitable and specific safeguards in place such as those set out in the Health Research Regulations.

Health Research Board

Questions (517)

Róisín Shortall

Question:

517. Deputy Róisín Shortall asked the Minister for Health if he will provide an update on the HSE Genetics and Genomics Programme. [12393/20]

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Written answers

As these are service matters, I have asked the Health Service Executive to respond to you directly, as soon as possible.

General Data Protection Regulation

Questions (518)

Róisín Shortall

Question:

518. Deputy Róisín Shortall asked the Minister for Health if genetic data collected by company (details supplied) may be transmitted outside of the EU. [12394/20]

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Written answers

The transfer by a data controller of personal data, including genetic data, outside the European Economic Area (EEA) is permitted subject to the provisions of Chapter 5 of the GDPR (Transfers of personal data to third countries or international organisations). The EEA encompasses the Member States of the EU plus Norway, Iceland and Liechtenstein. The question of compliance with the provisions in any particular case is for the Data Protection Commission.

General Data Protection Regulation

Questions (519)

Róisín Shortall

Question:

519. Deputy Róisín Shortall asked the Minister for Health when a company (details supplied) will make the genetic data of Irish patients freely and publicly available to the HSE [12395/20]

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Written answers

As these are service matters, I have asked the Health Service Executive to respond to you directly, as soon as possible.

Health Research Board

Questions (520)

Róisín Shortall

Question:

520. Deputy Róisín Shortall asked the Minister for Health the person or body that the appeal panels established to deal with appeals from decisions of the health research consent declaration committee is accountable to; and if decisions of the appeal panel can be challenged [12397/20]

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Written answers

The Health Research Regulations provide that the Appeal Panel is appointed by the Minister and like the Health Research Consent Declaration Committee it is purposely wholly independent in terms of its proceedings and decisions. The Regulations do not allow the Minister to amend, overturn or revoke decisions. Decisions of the Appeal Panel can be challenged by way of judicial review in the courts.

It should be noted that unlike the Consent Declaration Committee the Appeal Panel, under the Regulations, is not a standing committee. It stands dissolved when it has finished its work in relation to an appeal before it. That approach allows the membership of the panel to be selected to best reflect the skills set relevant to the particular appeal.

At present, the Regulations provide that the size of the panel is set at 3 persons. However, I am considering an amendment to increase the size to at least 3 and not more than 7 to facilitate a wider range of skills when appropriate.

Hospital Groups

Questions (521)

Róisín Shortall

Question:

521. Deputy Róisín Shortall asked the Minister for Health if each hospital group has a data protection officer; and if not, the person or body that assists patients with requests to access their health data records. [12398/20]

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Written answers

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

Vaccination Programme

Questions (522)

Róisín Shortall

Question:

522. Deputy Róisín Shortall asked the Minister for Health if he will review the decision to discontinue the BCG vaccine; if the HSE review of the epidemiology of tuberculosis here has been completed; and if he will make a statement on the matter. [12399/20]

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Written answers

The BCG vaccine is given to protect babies against tuberculosis (TB). It is important to note that the number of cases of TB in Ireland is low. A total of ten cases were reported in the 0-14 age group in 2019.

As of 2015, most European countries did not give the BCG vaccine routinely to all babies (Dierig et al, Vaccine, 2015).

In April 2015, due to a lack of vaccine from the sole EU supplier, the BCG vaccine became unavailable in Ireland. In 2015, the National Immunisation Advisory Committee (NIAC) recommended that the BCG vaccine does not need to be given to all children in Ireland. The Heath Information and Quality Authority (HIQA) published a Health Technology Assessment of BCG vaccine in Ireland in December 2015. This also concluded that BCG vaccination does not need to be given to all children in Ireland.

The HSE were requested, in 2019, to undertake an updated review of the epidemiology of TB in Ireland, considering the public health impact of having no BCG vaccination since April 2015. The intention is that this review will be used to inform an updated recommendation to my Department regarding the future provision of BCG vaccination in Ireland. Once the recommendation to my Department is received and considered, the Department will issue an instruction to the HSE on the future provision of BCG vaccination in Ireland.

Hospital Facilities

Questions (523)

Matt Carthy

Question:

523. Deputy Matt Carthy asked the Minister for Health if the HSE plans to refurbish the accident and emergency department of Cavan General Hospital; if so, the status of the project; and if he will make a statement on the matter. [12416/20]

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Written answers

The Health Service Executive has advised that a project to extend the Emergency Department (ED) and provide a 2nd resuscitation room at Cavan General Hospital (CGH) was approved by the HSE’s National Capital Steering Committee in November 2019, subject to the availability of funding.

The process of engaging a design team to progress this project was being initiated prior to the Covid19 Pandemic. The Covid19 Pandemic has placed additional stresses on all areas of acute hospitals, including ED’s and a design team has now been selected to progress this ED project whilst taking account the learnings presented by the Covid19 Pandemic.

The project will include a 2nd resuscitation room, additional clinical administration area and additional waiting area. We expect to have initial designs for review in Quarter 3 2020.

The delivery of capital projects is a dynamic process and is subject to the successful completion of the various approval stages, in line with the Public Spending Code, which can impact on the timeline for delivery.

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