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Tuesday, 7 Jul 2020

Written Answers Nos. 761-780

Hospital Facilities

Questions (761)

Alan Dillon

Question:

761. Deputy Alan Dillon asked the Minister for Health the details of the 2019 bed capacity programme, which previously included plans for ten additional beds in Mayo University Hospital; when the hospital will bring this extra capacity into operation; and if he will make a statement on the matter. [14163/20]

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Written answers

Saolta Hospital Group has advised that Mayo University Hospital have proposals for a mobile Acute Medical Assessment Unit on the site which would release 8 beds for inpatient use. They also envisage freeing up 2 further beds through an internal upgrade. These proposals will be considered in the context of priorities in the region and available resources.

Emergency Departments

Questions (762)

Alan Dillon

Question:

762. Deputy Alan Dillon asked the Minister for Health the position regarding the Mayo University Hospital emergency department development; if the steering group provided the requested information to the HSE on its application to ensure its inclusion in the HSE capital plan; and if he will make a statement on the matter. [14164/20]

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Written answers

My Department and the Health Service Executive are currently engaged in a process to develop the draft HSE Capital Plan for 2020. The HSE Capital Plan will determine the projects that can progress in 2020 and beyond having regard to the total available capital funding and the relevant priority of each project. All Health capital projects, currently at various stages of development, such as the project at Mayo University Hospital, are included as part of this process.

In developing its Capital Plan for 2020 and future years, the HSE must consider a range of issues including, the expenditure that is contractually committed, the HSE’s annual requirement in relation to meeting risks associated with clinical equipment, ambulances and healthcare infrastructure.

Once the HSE has finalised its Capital Plan for 2020, it will then be submitted to me for consideration.

Medical Cards

Questions (763)

Joe O'Brien

Question:

763. Deputy Joe O'Brien asked the Minister for Health when the national medical card unit is to be advised that the new thresholds for medical card eligibility as announced in budget 2020 are to come into effect; and if he will make a statement on the matter. [14171/20]

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Written 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.

Health Services Funding

Questions (764)

Alan Kelly

Question:

764. Deputy Alan Kelly asked the Minister for Health if funding provided to a person (details supplied) can be transferred to a person who would provide similar services in the home of the person as offered to them in a location; and if he will make a statement on the matter. [14172/20]

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Written answers

The Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives.

As the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.

Covid-19 Pandemic

Questions (765, 767)

Joe O'Brien

Question:

765. Deputy Joe O'Brien asked the Minister for Health his plans to conduct an inquiry into the rate of Covid-19 cases seen in nursing homes; and if he will make a statement on the matter. [14176/20]

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Joe O'Brien

Question:

767. Deputy Joe O'Brien asked the Minister for Health his plans to conduct an inquiry into the rate of Covid-19 cases seen in nursing homes; and if he will make a statement on the matter. [14187/20]

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Written answers

I propose to take Questions Nos. 765 and 767 together.

During the response to COVID-19, Nursing homes continue to be regulated by HIQA, who under the Health Act 2007 have the legal authority to examine the operation of any facility under their remit. Any individual cases of concern should be brought to the attention of HIQA and the relevant HSE Safeguarding and Protection Team

In addition, a series of enhanced measures have been agreed by NPHET for long-term residential care settings and these are currently being implemented by the HSE, HIQA and service providers. They include measure to support facilities which have outbreaks of COVID-19, measures aimed at stopping the transmission of the virus and support the provision of PPE to and screening of staff. All of these measures and actions are aimed at supporting the protection and provision of safe care of the residents of long-term care facilities.

On foot of a National Public Health Emergency Team (NPHET) recommendation, on 23 May a COVID-19 Expert Panel on Nursing Homes was established, to examine the complex issues surrounding the management of COVID-19 among this particularly vulnerable cohort.

The purpose of the Panel is to examine the national and international responses to the COVID-19 crisis, and to examine the emerging best practice. Its main objective is to provide immediate real-time learnings and recommendations in light of the expected ongoing impact of COVID-19 over the next 12-18 months. COVID-19 is a new disease, which can present atypically in the frail elderly, and new evidence and best practice in its management are constantly emerging. I expect the Expert Panel to submit their final report to me later this month.

Medicinal Products

Questions (766)

Brendan Griffin

Question:

766. Deputy Brendan Griffin asked the Minister for Health his views on matters raised in correspondence by a person (details supplied) in respect of the availability of drugs for the treatment of cancer for private and public patients; and if he will make a statement on the matter. [14177/20]

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Written answers

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 for decisions on the reimbursement of medicines.

In line with the 2013 Act and the national framework agreed with industry, a company must submit an application to the HSE to have a new medicine added to the reimbursement list.

Reimbursement is for licensed indications which have been granted market authorisation by the European Medicines Agency or the Health Products Regulatory Authority.

HSE decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds, on the advice of the National Centre for Pharmacoeconomics (NCPE).

The NCPE conducts health technology assessments (HTAs) for the HSE and makes recommendations on reimbursement to assist HSE decisions. The NCPE uses a decision framework to systematically assess whether a drug is cost-effective as a health intervention.

The HSE at all times ensures that the systems that it has in place are designed to provide equitable access to all medicines across all therapeutic areas, cancer and non-cancer, from the resources provided to it.

In 2019 and 2020, the Vhi decided to extend cover to a number of new cancer medicines. The decision by the Vhi applies only to private care to private Vhi patients in private hospitals. It has no impact on the availability and use of medicines in public hospitals, where there is no distinction between public and private patients.

A number of the medicines, or indications (which includes pembrolizumab and nivolumab), which the Vhi has now decided to cover, are in process with the HSE with a view to making them available in the public hospital system.

I am advised by the HSE that it has received pricing and reimbursement applications for the indications listed below:

- Nivolumab (Opdivo®) as monotherapy is indicated for the adjuvant treatment of adults with melanoma with involvement of lymph nodes or metastatic disease who have undergone complete resection.

- Pembrolizumab (Keytruda®) as monotherapy is indicated for the adjuvant treatment of adults with Stage III melanoma and lymph node involvement who have undergone complete resection.

The HSE has confirmed that health technology assessments have been completed by the NCPE for both these indications. These applications for reimbursement are now been assessed by the HSE in line with the 2013 Health Act.

Question No. 767 answered with Question No. 765.

Hospital Equipment

Questions (768, 769)

Louise O'Reilly

Question:

768. Deputy Louise O'Reilly asked the Minister for Health the number of CT scanners per million population; and the way in which this compares internationally with other countries, for example, South Korea, Iceland and Denmark. [14188/20]

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Louise O'Reilly

Question:

769. Deputy Louise O'Reilly asked the Minister for Health the purchase date of each CT scanner in hospitals here; and the sell-by date of each scanner. [14189/20]

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Written answers

I propose to take Questions Nos. 768 and 769 together.

As the Health Service Executive is responsible for the delivery of public healthcare services and infrastructure projects, I have asked the HSE to respond to you directly in relation to this matter.

Hospital Equipment

Questions (770)

Louise O'Reilly

Question:

770. Deputy Louise O'Reilly asked the Minister for Health the number of CT scanners per million of the population; the medically indicated number Ireland should have to deliver productive efficiency; and if he will make a statement on the matter. [14190/20]

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Written answers

I have asked the Health Service Executive to respond to the Deputy directly.

Health Services Staff

Questions (771)

Louise O'Reilly

Question:

771. Deputy Louise O'Reilly asked the Minister for Health his plans to allow staff recruitment processes to be devolved to local and hospital level. [14191/20]

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Written answers

I have asked the HSE to respond to the Deputy directly on this matter.

Hospital Staff

Questions (772)

Louise O'Reilly

Question:

772. Deputy Louise O'Reilly asked the Minister for Health the average recruitment time for a nurse to a public hospital in 2019. [14192/20]

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Written answers

I have asked the HSE to respond directly to the Deputy on this matter.

Nursing Staff

Questions (773)

Louise O'Reilly

Question:

773. Deputy Louise O'Reilly asked the Minister for Health the average recruitment time for a doctor to a public hospital in 2019. [14193/20]

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Written answers

I have asked the HSE to respond directly to the Deputy on this matter.

Hospital Staff

Questions (774)

Louise O'Reilly

Question:

774. Deputy Louise O'Reilly asked the Minister for Health the average radiographer recruitment time for a doctor to a public hospital in 2019. [14194/20]

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Written answers

I have asked the HSE to respond directly to the Deputy in relation to the average recruitment time for a radiographer to a public hospital as clarified by the Deputy.

National Children's Hospital

Questions (775)

Louise O'Reilly

Question:

775. Deputy Louise O'Reilly asked the Minister for Health if the policy of his predecessor will be pursued to allow the building of private treatment rooms in the new national children’s hospital. [14195/20]

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Written answers

The Programme for Government commits to finalising the new Slaintecare consultant contract and to legislating for public-only work in public hospitals.

Currently, as part of the Common Contract for Consultants negotiated in 2008, many consultants holding specific contracts are entitled to engage in private outpatient practice outside of their public commitment. The 2008 Common Contract obliges the employer to provide facilities on the hospital campus for outpatient private practice and the provision of such facilities off-campus, on an interim basis, pending provision of on-campus facilities. Private clinics are currently located on the grounds of each the existing three children’s hospitals. The new children's hospital is obliged to provide such facilities for consultants holding these contracts.

Accordingly, while the vast majority of services in the new children’s hospital will be public services, within the new hospital an area has been planned which carries the designation of "private clinic". The private outpatient clinic at the new children’s hospital represents circa 0.25% of the clinical space within the new children’s hospital. There are a total of 129 outpatient clinical exam rooms primarily accessed off the main concourse on the ground and lower ground floor of the new children’s hospital, each of which are identical in design and fit out. There are 8 clinical exam rooms in the private clinic.

Ultimately, the proposal is for consultants to pay a fee for use of private rooms and other operational costs. The proposed level of fee has not been determined yet.

It is important to recognise that the capacity being planned for the new children’s hospital is national capacity based upon the assessment of healthcare needs and future demographic developments. Accordingly, these clinic rooms will be required to meet the estimated demand for paediatric outpatient and inpatient services, whether publicly or privately provided.

Covid-19 Pandemic

Questions (776)

Louise O'Reilly

Question:

776. Deputy Louise O'Reilly asked the Minister for Health the estimated average theatre, operation and treatment time that will be lost per 12 hour period due to the need to clean theatres and suites after each procedure and treatment to ensure adherence to Covid-19 infection control measures. [14196/20]

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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.

Health Services Funding

Questions (777)

Maurice Quinlivan

Question:

777. Deputy Maurice Quinlivan asked the Minister for Health the resources that will be made available to increase capacity in the public health sector for access to diagnostics and the urgent recommencement of cancer screening programmes and access to time critical reviews for patients on surgical waiting lists. [14197/20]

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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.

Health Services Funding

Questions (778)

Maurice Quinlivan

Question:

778. Deputy Maurice Quinlivan asked the Minister for Health the resources that have been assigned to build the capacity required to tackle the outpatient waiting lists for routine diagnostics, for example, cardiology and radiological scans. [14198/20]

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Written answers

The HSE advises that a pilot project commenced in 2016 by the HSE Acute Hospitals Division to progress the collection of national radiology waiting list data. The project has been supported by the Radiology Clinical Care Programme and has involved key stakeholders across the system including the National Integrated Medical Imaging System (NIMIS) Team, Hospital Groups, and the support of the National Treatment Purchase Fund (NTPF) for data collection and data management expertise.

At present, the pilot project collects data relating to CT, MRI and Ultrasound. In Q1 2020, there were a total of 190,373 patients reported on the waiting list from all sites, this represents all outpatients waiting, urgent, semi urgent, routine and planned/surveillance (where diagnostic access is planned at particular time intervals).

In terms of medium-term planning for additional diagnostic capacity, the National Development Plan states that, new dedicated ambulatory elective only hospital facilities will be introduced in Dublin, Galway and Cork. As per the Development plan, these facilities will provide high volume, low complexity procedures on a day and outpatient basis, together with a range of ambulatory diagnostic services.

As part of the wider Sláintecare implementation, the Elective Hospitals Oversight Group, established by the Department of Health, is currently developing a high-level facilities spatial brief and order of magnitude costs which details the elective clustering of appropriate activities for each of the three facilities in Dublin, Cork and Galway. This will also include an output and facility specification, based on efficient and effective service delivery, which will include diagnostic procedures. This is due to be completed in the Autumn of 2020.

Health Services Funding

Questions (779)

Maurice Quinlivan

Question:

779. Deputy Maurice Quinlivan asked the Minister for Health if the necessary recruitment and investment will be increased for hospital consultants and healthcare science staff required to boost capacity in diagnostic services in view of the reduced capacity of HSE diagnostic pathways. [14199/20]

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Written answers

The Programme for Government recognises that significant additional capacity is required in the context of responding to COVID-19. It also recognises that, in addition, even before its impact, additional capacity would be required to provide access to quality services and to meet the needs of our growing population.

Work is ongoing in the Department and in the HSE to quantify what the public health sectors workforce requirements will be going forward across all services, including capacity requirements to ensure sufficient diagnostic services. The provision of diagnostic services is a key platform of Sláintecare and will be a priority in the months and years ahead.

Medical Aids and Appliances

Questions (780)

Maurice Quinlivan

Question:

780. Deputy Maurice Quinlivan asked the Minister for Health if medical grade masks will be supplied to persons with serious health issues. [14200/20]

View answer

Written answers

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.

Based on current advice there are no plans to supply face coverings.

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 Government has agreed to the mandatory use of face coverings mandatory on public transport and the development of Regulations in this regard is under way.

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