Paul McAuliffe
Question:742. Deputy Paul McAuliffe asked the Minister for Health if the possibility of allowing pharmacists to administer the 'flu vaccine in the homes of persons will be examined. [14113/20]
View answerVaccination Programme
Questions (742)
Written answers
An expansion to the seasonal influenza vaccine programme is planned for winter 2020/2021. Under the expansion, the influenza vaccine is to be made available without charge to all children aged between 2 and 12 years inclusive, and to all of those in the HSE-defined at-risk groups aged from 6 months to 69 inclusive. All persons aged over 70 already have access to the vaccine without charges.
Work is currently underway to develop plans to operationalise this policy. The possibility of pharmacists being enabled to administer vaccinations outside of a Retail Pharmacy Business is being examined as part of process.
General Practitioner Services
Questions (743)
Frank Feighan
Question:743. Deputy Frankie Feighan asked the Minister for Health if he will request the HSE to revisit the Drumshanbo health centre in order to reassess the capacity of the building and the need in the locality for expansion of the general practitioner service to a five-day service in order to cater for patient demand in the area; and if he will make a statement on the matter. [14120/20]
View answerWritten answers
As this question relates to a service matter, I have arranged for the question to be referred to the Health Service Executive for direct reply to the Deputy.
Primary Care Centres
Questions (744)
Seán Canney
Question:744. Deputy Seán Canney asked the Minister for Health when he envisages diagnostic equipment will be installed in the primary care centre in Tuam, County Galway, in view of the fact his predecessor allocated a sum of €770,000 for the installation of such facilities; and if he will make a statement on the matter. [14121/20]
View answerWritten answers
As the HSE has responsibility for the provision, along with the maintenance and operation of Primary Care Centres and other Primary Care facilities, the Executive has been asked to reply directly to the Deputy.
Hospital Appointments Status
Questions (745)
Robert Troy
Question:745. Deputy Robert Troy asked the Minister for Health if an appointment will be expedited for a person (details supplied). [14122/20]
View answerWritten 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 Appointments Status
Questions (746)
Peter Fitzpatrick
Question:746. Deputy Peter Fitzpatrick asked the Minister for Health when a person (details supplied) will receive an appointment for surgery in Our Lady of Lourdes Hospital, Navan; and if he will make a statement on the matter. [14125/20]
View answerWritten 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 (747)
Duncan Smith
Question:747. Deputy Duncan Smith asked the Minister for Health the steps he will take to ensure persons (details supplied) are issued with their over-70s medical card which has expired; and if he will make a statement on the matter. [14128/20]
View answerWritten answers
As this is a service matter, it has been referred to the Health Service Executive for direct reply to the Deputy.
Medical Cards
Questions (748)
Robert Troy
Question:748. Deputy Robert Troy asked the Minister for Health when the income limits for over-70s medical cards will be reviewed in accordance with the decision in budget 2020. [14134/20]
View answerWritten answers
On 25th June, the Government gave approval for the publication of the Health (General Practitioner Service and Alteration of Criteria for Eligibility) Bill 2020. This Bill provides, amongst other things, for the necessary legislative amendments to increase the weekly gross medical card income limits for those aged 70 and over. The Bill was published on July 1st, 2020 and arrangements are now being made for its passage through the Houses of the Oireachtas.
Covid-19 Pandemic Supports
Questions (749)
David Cullinane
Question:749. Deputy David Cullinane asked the Minister for Health the status of PPE provision and financial support for the homecare sector in view of the importance of the service to older persons in general but also in particular in further view of the severe implications of the Covid-19 pandemic for older persons; his plans for the same; and if he will make a statement on the matter. [14144/20]
View answerWritten answers
Standard PPE will continue to be the responsibility of private providers for non-COVID-19 clients. However, HSE will provide appropriate additional PPE supplies to Home Support Providers in relation to clients confirmed to have COVID-19 on the clear understanding that the individual service provider will deliver appropriate Infection Protection and Control training to its staff.
However as this is a service matter I have referred this matter to the HSE for direct reply.
Health Services Staff
Questions (750)
David Cullinane
Question:750. Deputy David Cullinane asked the Minister for Health the position regarding the HSE pay policy for the homecare sector. [14145/20]
View answerWritten answers
The Public Sector Stability Agreement is the mechanism which provides for public service pay policy as well as the terms and conditions of public sector employment.
All public health sector employees are paid in line with Department of Health Consolidated Salary Scales, and this document can be publicly viewed online at this website
https://www.hse.ie/eng/staff/resources/hr-circulars/1-january-2020-consolidated-payscales-final-corrected-version-003-.pdf
The salary scale for Health Care Support Assistants (formerly known as Home Helps) can be found on Page 27 of this document.
Medicinal Products
Questions (751, 784)
Peter Burke
Question:751. Deputy Peter Burke asked the Minister for Health if he will examine the standard treatment plan and drug use for those suffering with stage III melanoma; if he will authorise the use of nivolumab and pembrolizumab for this condition in the public system in view of the fact it is currently the authorised treatment for this condition in the private health system; and if he will make a statement on the matter. [14146/20]
View answer
Niamh Smyth
Question:784. Deputy Niamh Smyth asked the Minister for Health if patients diagnosed with melanoma in the public health system here are only offered immunotherapy when in stage IV of the illness; the reason such treatment is not offered at stage III in view of the fact that half of patients at this stage advance to the next; his views on whether more lives would be saved if persons were offered such treatment earlier; if his attention has been drawn to the fact that adjuvant immunotherapy nivolumab, pembrolizumab and targeted therapy are available to some with private health insurance here but the public health service is not funding the medications; his further views on whether this is consistent with the goals of the National Cancer Strategy; and his plans to improve stage III melanoma treatments. [14210/20]
View answerWritten answers
I propose to take Questions Nos. 751 and 784 together.
The HSE's National Cancer Control Programme (NCCP) advise that Nivolumab and Pembrolizumab are licensed by the European Medicines Agency as monotherapy for the treatment of advanced melanoma in adults and are approved by the HSE for reimbursement in public hospitals. A Health Technology Assessment has been completed that looks at the use of these drugs as monotherapy for the adjuvant treatment of adults with Stage III melanoma and the approval process for the reimbursement of these drugs is ongoing.
The HSE has a standard assessment process in place for the approval of the reimbursement of new drugs and new indications for existing drugs. This process is intended to arrive at decisions on the funding of drugs that are clinically appropriate, fair, consistent and sustainable. The reimbursement process is underpinned by the Framework Agreement on the Supply and Pricing of Medicines (2016) and the Health (Pricing and Supply of Medical Goods) Act 2013.
Before a medicine is licensed for use in the European Union, and before it can be marketed for sale in the EU, it must receive a market authorisation from the European Medicines Agency. Once drugs are licensed, the company may apply for HSE reimbursement approval using the standard process.
The Department of Health, along with the NCCP and the wider HSE, work together in advancing the process of securing such drugs at affordable cost once the European Medicines Agency (EMA) has approved them for clinical use.
Finally, my Department cannot comment on the business decisions taken by private health insurers with regard to the medicines covered under their schemes.
Hospital Appointments Status
Questions (752)
Bernard Durkan
Question:752. Deputy Bernard J. Durkan asked the Minister for Health if urgent spinal surgery will be facilitated in the case of a person (details supplied); if urgent HALO traction treatment can be accommodated as soon as possible; and if he will make a statement on the matter. [14149/20]
View answerWritten 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.
Disability Services Provision
Questions (753)
Martin Browne
Question:753. Deputy Martin Browne asked the Minister for Health when adult day services for persons with disabilities will reopen in view of the fact the HSE framework for the resumption of adult disability day services offers no clarity on the reopening of services; and the procedures his Department has put in place to ensure persons with disabilities and carers are not left behind as the country reopens. [14151/20]
View answerWritten 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 have completed the above strands of work, which will inform the timeline for the phased re-opening of day services. It is expected that a the HSE will issue guidance in the coming days on the resumption of services. 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.
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
Covid-19 Pandemic
Questions (754)
Robert Troy
Question:754. Deputy Robert Troy asked the Minister for Health the guidance for those aged 70 years of age or over, in particular when those within this age category can return to work. [14154/20]
View answerWritten answers
As the Deputy is no doubt aware, those over 70 and the extremely medically vulnerable are at a very high risk of severe illness from COVID-19 and are advised to follow cocooning measures in order to keep themselves safe. However, it is important that people who are cocooning feel empowered to exercise their own judgement regarding the extent to which they consider the cocooning guidance is appropriate to their individual circumstances.
For people in very high risk groups, such as the over 70s, who wish to visit others, receive visitors in their home, attend shops, and engage in other activities, it is recommended that they (and their visitors) maintain strict hand hygiene and respiratory etiquette, continue to adhere to the physical distancing guidance of 2 metres, avoid touching surfaces and clean surfaces touched by visitors, and ideally use face coverings when attending the shops or other busy public areas.
Those in high risk groups who are planning to travel within and outside their region should acquaint themselves with the level of transmission of the virus in the relevant area, and consider how best to protect themselves. The latest statistics can be found on the COVID-19 Data Hub: https://covid19ireland-geohive.hub.arcgis.com/
I would like to draw the Deputy's attention to the “Return to Work Safely Protocol - COVID-19 Specific National Protocol for Employers and Workers” which was published on 9 May, 2020. 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. This Protocol is mandatory, and it applies to all workplaces right across the economy. Specific sectors may need to introduce additional safeguards, but this document sets the standard set of measures to provide protection against the threat of COVID-19.
The Health and Safety Authority (HSA) is tasked with providing advice and support to employers and employees on what and how COVID-19 measures are applied in the workplace. If you would like any further guidance on the Protocol, the HSA Helpline can be contacted at 1890 289 389 or wcu@hsa.ie.
Further information on high risk groups and practical guidance for those cocooning is available from the Government and the HSE at the following links:
https://www.gov.ie/en/publication/923825-guidance-on-cocooning-to-protect-people-over-70-years-and-those-extr/
https://www2.hse.ie/conditions/coronavirus/cocooning.html
Health Services Staff
Questions (755)
Louise O'Reilly
Question:755. Deputy Louise O'Reilly asked the Minister for Health the number of consultant vacancies across the public health service; and his plans to recruit consultants to fill these vacancies. [14155/20]
View answerWritten answers
I have asked the HSE to reply directly to the Deputy on this matter.
Health Services Staff
Questions (756, 824)
Louise O'Reilly
Question:756. Deputy Louise O'Reilly asked the Minister for Health his plans to award public health doctors the same status as hospital consultants and deliver an increase in their remuneration. [14156/20]
View answerRobert Troy
Question:824. Deputy Robert Troy asked the Minister for Health the status of negotiations regarding public health consultant contracts. [14326/20]
View answerWritten answers
I propose to take Questions Nos. 756 and 824 together.
My Department in conjunction with the HSE, and having engaged with key stakeholders, was in the process of finalising a new framework for public health prior to the onset of COVID-19. This body of work was to reflect the recommendations of the report reviewing the specialty undertaken by Crowe Horwath published in December 2018, and also the vision outlined for the specialty in Sláintecare and in the Report of Dr Scally on the National Screening Service ('CervicalCheck').
Prior to the issue of COVID-19 arising, it was envisaged that the finalisation of the design of the new service delivery model would be completed in the second half of 2020. Work on the model is now being resumed. It will be refined and validated having regard to COVID-19 and a strategic workforce plan developed and aligned to the new model.
Engagement with the IMO on the twin issues of consultant status and remuneration for public health specialists has been ongoing since January 2019 in tandem with the broader body of work. The Department and the HSE have indicated their support for consultant status in this engagement.
It is my intention that public health specialists will be awarded consultant status under the new framework and that their remuneration will be increased accordingly in return for significant structural and organisational reform within the Specialty.
It is noted that the FEMPI Acts currently prohibit pay increases for serving public servants and that this legislation will require amendment to enable pay increases for pubic health consultants and also serving 'new entrant consultants' taking up the Slaintecare 'public only' consultant contract.
General Practitioner Services
Questions (757)
Louise O'Reilly
Question:757. Deputy Louise O'Reilly asked the Minister for Health the number of general practitioners who started on a general practitioner training scheme in 2019; the number of places that can be catered for on the training scheme; if the number of training places will be increased in 2020; and if so, the number to which. [14157/20]
View answerWritten answers
192 medical graduates entered the GP training programme in 2019. The number entering the programme has increased steadily in recent years from 120 in 2009. Capacity for training places will be further increased this year with 217 places made available.
It is intended that the transfer of responsibility for training General Practitioners from the HSE to the Irish College of General Practitioners will take place in 2020, pending the resolution of certain outstanding issues, and that this will allow for a further expansion in the number of training places in future years.
Health Services Funding
Questions (758)
Louise O'Reilly
Question:758. Deputy Louise O'Reilly asked the Minister for Health the level of public investment in healthcare per patient; and the way in which this compares with the European Union average. [14158/20]
View answerWritten answers
The OECD’s System of Health Accounts (SHA) enables international comparison of Healthcare expenditure (HCE) by tracking all HCE in a country over a defined period of time. HCE is presented in relation to each country’s economy, measured as a share of GDP, or to its population, measured as per capita health spending. The OECD applies a purchasing power parity (PPP) adjustment to countries’ HCE, reflecting relative prices/costs across countries. This provides for a comparable measure of the volume of services supplied per capita across countries. The measure is expressed in US dollars. Furthermore, the OECD classify HCE according to the financing of healthcare which allows for more detailed analyses. The classifications of healthcare financing sources include ‘public financing’ which is defined as Government and compulsory contributory healthcare financing schemes. Reviewing the SHA public healthcare expenditure for 2019, Ireland’s expenditure per capita was US$ PPP 3,919. This puts Ireland in 9th place compared to the rest of EU countries. The EU27 average public healthcare expenditure in 2019 was US$ PPP 2,872 per capita.
This data is publicly available at https://stats.oecd.org/.
It is important to note that 2019 is the latest OECD SHA data available, and therefore does not account for the impact of COVID -19 on HCE across OECD countries. It is also important to note, that the OECD cautions about comparability limitations in relation to the SHA. Challenges in achieving cross-country comparability of HCE arise particularly from the differing approaches taken by countries to organising and accounting for their social care systems. As part of my Department’s Joint Research Programme in Healthcare Reform with the Economic and Social Research Institute, a paper is currently being prepared for publication which will examine in detail how Irish HCE compares internationally with the aim of distinguishing the effects on comparisons of healthcare prices and volumes, accounting issues and health system characteristics.
I hope this clarifies the matter for the Deputy.
National Children's Hospital
Questions (759)
Louise O'Reilly
Question:759. Deputy Louise O'Reilly asked the Minister for Health the reason work has stopped on the national children’s hospital; if there are legal proceedings under way regarding the project; the estimated cost to the State of such legal proceedings; the number of days lost due to legal proceedings; and the cost to the State per day of delays to the project. [14159/20]
View answerWritten answers
I am aware that construction work on the new children’s hospital site beside St. James’s Hospital stopped on 31 March 2020 as a result of the Covid-19 pandemic.
I understand that since the commencement of the easing of restrictions on 18 of May, the National Paediatric Hospital Development Board (NPHDB) has been engaging with the main contractor in relation to the earliest possible reopening of the site. I have been informed that some matters remain unresolved at this time and that construction has not recommenced.
The proceedings currently before the Commercial Court are not related to the closure of the site on 31 March, 2020 but to the validity of the instruction given by the NPHDB to begin the Phase B above ground construction works in January 2019. As this matter is now before the Courts it would be inappropriate to comment further at this time.
I am anxious that the hospital be completed as quickly as possible on behalf of children, young people and their families. The NPHDB has statutory responsibility for planning, designing, building and equipping the new children's hospital and I have referred your question to the NPHDB for direct reply.
Covid-19 Pandemic
Questions (760)
Michael Healy-Rae
Question:760. Deputy Michael Healy-Rae asked the Minister for Health the current advice regarding meetings (details supplied); and if he will make a statement on the matter. [14161/20]
View answerWritten answers
Guidelines in relation to the meetings of Local Authorities as described in the Deputy’s question are not matters within the remit of my Department. Public health advice in operation at a point in time is available on the Government website at http://www.gov.ie/
I would like to draw the Deputy's attention to the “Return to Work Safely Protocol - COVID-19 Specific National Protocol for Employers and Workers” which was published on 9 May, 2020. 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. The Protocol is mandatory, and it applies to all workplaces right across the economy. Specific sectors may need to introduce additional safeguards, but this document sets the standard set of measures to provide protection against the threat of COVID-19.
The Health and Safety Authority (HSA) is tasked with providing advice and support to employers and employees on what and how COVID-19 measures are applied in the workplace. If you would like any further guidance on the Protocol, the HSA Helpline can be contacted at 1890 289 389 or wcu@hsa.ie.