Written Answers Nos. 1172-1197
1172. Deputy David Cullinane asked the Minister for Health the number of whole-time equivalent consultant psychiatrists working in the mental health unit in Waterford in each of the years 2018 and 2019 and to date in 2020; and if he will make a statement on the matter. [15451/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
1173. Deputy David Cullinane asked the Minister for Health his views on the most recent report of the Mental Health Commission; the actions that will be taken; and if he will make a statement on the matter. [15452/20]
View answerThe Mental Health Commission’s Annual Report for 2019 was launched on 2 July.
I welcome this report as it provides an important independent insight into where the mental health system is performing well and where improvement is required.
Some of the issues raised by the Commission will be addressed by the recently launched national mental health policy, Sharing the Vision – A Mental Health Policy for Everyone. This policy makes recommendations on service access, coordination and continuity of care, social inclusion, accountability and continuous improvement, among others. In addition, the review of the 2001 Mental Health Act, on which work is ongoing, will help to put in place a more robust framework in which mental health services can be delivered.
While I am pleased that there has been an overall improvement in regulatory compliance in recent years, it is clear that further improvement is needed. I will, with my Department, continue to work closely with both the Commission and the HSE to ensure that issues highlighted in this Annual Report are addressed.
1174. Deputy David Cullinane asked the Minister for Health the timetable for the construction and delivery of the second cath lab at University Hospital Waterford; and if he will make a statement on the matter. [15453/20]
View answerThe Estates unit in the Health Service Executive has been tasked with the delivery of additional capacity (infrastructure and equipment) nationwide in the effort for the containment and prevention of the spread of the Coronavirus - COVID-19. This has resulted in delays to works and schedules.
Funding has been allocated in the Capital Plan for the provision of 2nd Cath Lab at University Hospital Waterford. Planning Permission is in place for this project and applications for fire and disability certification are currently in progress. It is anticipated the project will go to tender in late August / early September – subject to approval. As required by OGP, tender is a 2 stage process for Main and Specialist contractors. This process will take approximately 4 months.
At present the draft Capital Plan 2020 is being reviewed and revised to take account of the impact of Covid-19 which resulted in delays on many projects and the funding of an emergency Covid-19 programme of works. Once the HSE has finalised its Capital Plan for 2020, it will then be submitted to me for consideration.
1175. Deputy David Cullinane asked the Minister for Health his plans with regard to the provision of 24-7 emergency cardiac care at the primary percutaneous coronary intervention, PCI, centre in Waterford; and if he will make a statement on the matter. [15454/20]
View answerIn 2016, the Herity Report concluded that the needs of the effective catchment population of University Hospital Waterford (UHW) could be accommodated from a single cath lab and recommended that the operating hours of the existing cath lab should be extended.
The HSE has advised that an additional Consultant Interventional Cardiologist post to support a seven (7) day; 8 am – 8 pm service in the existing Cath Lab was advertised by the Public Appointment Service on 27 September 2019. Interviews for this position took place on 27 January 2020, the post is now at the final stages of recruitment through the Public Appointment Services and it is expected that it will be filled very soon.
The Programme For Government commits to the delivery of a second cath lab in University Hospital Waterford. As set out in the HSE’s options appraisal, the preferred option is for a second cath lab and associated 12 bed day ward (delivering six additional beds) on the roof of the existing Cardiology Department, which will operate five days per week and provide diagnostic services only.
The HSE has advised that funding was allocated in the 2019 Capital Plan for the provision of second cath lab at University Hospital Waterford, planning permission was received from Waterford City and County Council in January 2020. Applications for fire and disability certification are currently in progress. Preparation of contract documentation has commenced and contractor selection is underway. Works and schedules were delayed due to COVID-19, but it is now anticipated that the project will go to tender in late August/early September.
The Herity Report also recommended that the current 9 to 5 provision of emergency pPCI services should cease to allow the hospital focus on the much larger volume of planned work. The then Minister for Health asked the Department to address the implications of this recommendation by arranging for a National Review of Specialist Cardiac Services.
The National Review of Specialist Cardiac Services commenced in January 2018 under the Chairmanship of Professor Phillip Nolan and a Steering Group was formed from nominations from interested stakeholders representing medical, professional/technical staff, nursing and patient representatives.
The aim of this Review is to achieve optimal patient outcomes at population level with particular emphasis on the safety, quality and sustainability of the services that patients receive by establishing the need for an optimal configuration of a national adult cardiac service.
While it is hoped that the National Review of Specialist Cardiac Services can be completed in the near future so that decisions can be made with regard to the continued investment and upgrading of Specialist Cardiac Services in Ireland, the impact of the COVID-19 pandemic has, unfortunately, had an adverse impact on its progression.
1176. Deputy Catherine Connolly asked the Minister for Health further to Parliamentary Question No. 556 of 30 June 2020, when the national guidelines will be published (details supplied); and if he will make a statement on the matter. [15460/20]
View answerI am advised that the HSE is currently engaged in detailed operational planning across the primary and community sector that will underpin the phased resumption of community services over the period ahead. This work will align with the recently published document “Service Continuity in a COVID Environment – A Strategic Framework for Delivery” which is available on the HSE’s website at https://www.hse.ie/eng/services/news/newsfeatures/covid19-updates/service-continuity-in-a-covid-environment-a-strategic-framework-for-delivery.pdf.
1177. Deputy Catherine Connolly asked the Minister for Health the number of day centres in Galway city and county that have closed since mid-March 2020 as result of Covid-19; the location of and service provided by each centre; the number of users deprived of services as a result of the closures; the analysis undertaken by HSE community healthcare west in regard to the closures and the impact on users; if he will provide a copy of same; and if he will make a statement on the matter. [15464/20]
View answerThe 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.
1178. Deputy Alan Kelly asked the Minister for Health the status of the restoration of funding for an organisation (details supplied); if the funding will be restored ahead of the proposed Clonburris development; and if he will make a statement on the matter. [15466/20]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
1179. Deputy Richard Bruton asked the Minister for Health the revised income limits due to come into force in July 2020 for medical cards; and if the HSE is now processing applications under these new guidelines. [15468/20]
View answerThe Health (General Practitioner Service and Alteration of Criteria for Eligibility) Bill 2020 was published on 1 July. 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 to €550 per week for a single person (currently €500 per week) and to €1,050 for a couple (currently €900 per week).
The Bill is expected to proceed through the Houses of the Oireachtas in mid-July.
1180. Deputy Paul McAuliffe asked the Minister for Health if he will examine the possibility of restoring free dental benefits, namely, a free clean and polish, for the over-70s. [15475/20]
View answerThe Dental Treatment Services Scheme (DTSS) provides dental treatments to medical card holders. Services currently available annually include an examination, two fillings and emergency extractions. Other more complex care is also provided, some of which requires prior approval by a Principal Dental Surgeon. Patients with special needs and high risk patients can avail of a broader range of treatments. This includes free scale and polish for those who are considered to be at high risk.
Smile agus Sláinte, the National Oral Health Policy, published in April 2019, includes proposals for the introduction of packages of oral healthcare for adult medical card holders at different intervals during their life course. The packages will focus on prevention and will include examinations, advice, and preventive therapies such as scale and polish. The timeframe for the delivery of the Policy is up to 2026 and the roll-out of these packages of care will take place incrementally over the next number of years. Routine care including fillings and complex care will continue to be available.
1181. Deputy David Cullinane asked the Minister for Health his views on the abolition of car parking charges at public hospitals; and if he will make a statement on the matter. [15478/20]
View answerThe Programme for Government makes a commitment to introduce a cap on the maximum daily charge for patients and visitors at all public hospitals, where possible and to introduce flexible passes in all public hospitals for patients and their families.
This issue has been under active consideration in recent years. The HSE conducted a review of hospital car parking charges and submitted their report to the Department of Health in December 2018. My Department and the HSE are currently engaging on this issue in order to achieve this new Programme for Government commitment.
1182. Deputy David Cullinane asked the Minister for Health the timeline for the construction of the national children’s hospital; the estimated cost; and if he will make a statement on the matter. [15479/20]
View answerThe 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.
1184. Deputy David Cullinane asked the Minister for Health his views on the expansion of neonatal screening; the action he will take in this regard; and if he will make a statement on the matter. [15482/20]
View answerThe National Screening Advisory Committee (NSAC) was established in 2019 and has held two meetings to date. The Committee’s role is to undertake an independent assessment of the evidence for screening for a particular condition against internationally accepted criteria and make recommendations accordingly.
Professor Niall O’Higgins was appointed as Chair of the NSAC in 2019 and was asked that the Committee prioritise an examination of the approaches for the expansion of the National Newborn Bloodspot Screening Programme ('heelprick test') and work in that regard has been progressed by the Committee.
It is most likely that over the course of the next 5 years we are likely to see an incremental expansion of the bloodspot programme that will screen for new conditions.
The next meeting is scheduled to take place on 17 July 2020 where the Committee will consider (1) the addition of ADA-SCID to the blood spot screening programme and (2) a change in the screening pathway of the Diabetic RetinaScreen programme.
Any future potential changes to the National Newborn Bloodspot Screening Programme will be incorporated as part of the Committee's work programme. Updates in relation to the work of the Committee will be posted on the NSAC website available at https://www.gov.ie/en/campaigns/nsac/.
1185. Deputy David Cullinane asked the Minister for Health his plans to extend free general practitioner care for children; and if he will make a statement on the matter. [15483/20]
View answerOn 25 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 phased expansion of GP care without fees to all children aged 12 years and under. The Bill was published on July 01, 2020 and it is expected to proceed through the Houses of the Oireachtas in mid-July.
The initial stage of this phased expansion will be the provision of GP care without fees to all children aged between 6 and 8. I am currently reviewing the situation in relation to this expansion to determine how and when this expanded service can be introduced in a way which will meet the ongoing health needs of children and will also be sustainable for General Practice in the current COVID environment.
1186. Deputy David Cullinane asked the Minister for Health his plans to extend free dental care for children; the timeline to deliver this; and if he will make a statement on the matter. [15484/20]
View answerThe Public Dental Service of the HSE treats children up to 16, and persons of all ages with special needs, through its dental clinics. All HSE dental clinics prioritise emergency care for children up to 16, treatment for special needs patients and screening of children aged from 11 to 13 years, including referral for orthodontic services where necessary.
Smile agus Sláinte, the National Oral Health, which was published in April 2019 supports a preventive approach to oral healthcare. It includes proposals for the introduction of packages of care for children from birth to 16 years of age to be delivered by contracted local dental practices and preventive packages of care to be made available for all eligible adults at different intervals during their life course.
The timeframe for the delivery of the Policy is 2019 to 2026 and the roll-out of these packages of care will take place incrementally. An early priority of the new Policy was the roll-out of packages of care for children under 6 in 2020, however, this has been delayed because of the necessary concentration of resources at managing the current COVID-19 pandemic.
1187. Deputy David Cullinane asked the Minister for Health his plans to hire additional dentists, orthodontists and dental nurses in the public system; and if he will make a statement on the matter. [15485/20]
View answerSmile agus Sláinte, the new National Oral Health Policy provides the groundwork to transform oral health services over the next eight years. The community oral healthcare services will centre on vulnerable and special care support services, as well as on needs assessment for people in residential settings and others who require additional supports.
The Policy recognises the need for a suitably skilled workforce to provide appropriate oral healthcare across all settings. This workforce will include oral healthcare professionals providing the highest level of care in advanced oral healthcare centres or in secondary/tertiary care centres, as well as oral healthcare professionals providing oral healthcare advice and preventive care directly to the public in primary oral healthcare settings. A protected educational, training and research environment will be a priority for the implementation of the Policy.
The detail of workforce requirements will be agreed as part of the implementation process. At present it remains difficult to quantify what the public health sector's future workforce requirements will be, as we are still in the process of managing the current COVID-19 crisis. Once the full impact of the pandemic is understood, the service requirements and available resources will determine the extent to which recruitment may be required.
1188. Deputy David Cullinane asked the Minister for Health the wait times for orthodontic treatment by region and wait time of zero to one, one to two, two to three, three to four and more than four years, respectively in tabular form; and if he will make a statement on the matter. [15486/20]
View answerAs this is a service matter it has been referred to the HSE for attention and direct reply to the Deputy.
1189. Deputy David Cullinane asked the Minister for Health the number of general practitioners employed in each primary care centre; and if he will make a statement on the matter. [15487/20]
View answerAs the Health Service Executive has responsibility for the provision and operation of Primary Care Centres, I have arranged for the question to be referred to the HSE for direct reply to the Deputy.
1190. Deputy David Cullinane asked the Minister for Health his plans to fully implement the recommendations of the Scally report and, specifically, actions and time frames to deliver it; and if he will make a statement on the matter. [15488/20]
View answerThe implementation plan for the recommendations of the Scally inquiry was approved by Government on 11 December 2018. The implementation plan contains 170 actions. At the end of Q1 2020, 137 of the 170 identified actions were completed.
I fully support the full implementation of the recommendations of Dr Scally and am committed to publishing a quarterly progress report against the recommendations on the Department of Health website. There has been significant progress by all parties to date and my Department engages on an ongoing basis with the HSE and the National Cancer Registry to oversee implementation of the recommendations.
Given the challenges that have arisen due to the COVID-19 pandemic some of the remaining work on the implementation of the recommendations has not been progressed. The HSE are currently developing capacity planning for the ongoing delivery of COVID-19 and non COVID-19 care and services side by side. Work on implementing the remaining recommendations will be re-prioritised in line with this process.
1191. Deputy David Cullinane asked the Minister for Health his views on an independent inquiry into the use of sodium valproate; and if he will make a statement on the matter. [15489/20]
View answerI have previously gone on record as stating that I would support an inquiry into the use of sodium valproate in this country. On 8 July, the Independent Medicines and Medical Devices Safety Review in the UK published its report into sodium valproate and two other medical interventions. I have asked officials in my Department, as well as in the HSE and the Health Products Regulatory Authority, to consider the findings of this report and provide me with comprehensive briefing before I consider the next steps in addressing the issue of sodium valproate use in Ireland.
1192. Deputy David Cullinane asked the Minister for Health his plan to increase home support hours; the number of increased hours he plans to deliver over the lifetime of the Government; if he has a target for each year; and if he will make a statement on the matter. [15490/20]
View answerCOVID-19 is posing significant challenges for many areas of our Older People Services, including Home Support Services. In light of these unprecedented challenges, the HSE, at the outset, had to reassess its operation of Home Support Services nationally, to ensure that the assessed needs of those clients with the highest priority were and still are being met. The HSE, working with its approved home support service providers are endeavouring to maintain essential support services during this unprecedented public health emergency. In this context, the HSE has set out a prioritisation process for home support, which looks at delivering a service based on priority need across 4 priority categories.
As a result of that review of prioritisation, a number of clients with lower priority needs had their home support service temporarily ceased or reduced with the support of family members and/or alternative forms of volunteer provided local supports. In these cases, each client was contacted to advise of the assessment and decision, alternative support available and assistance given to ensure that essential requirements continue to be provided. The HSE continues to review both those clients whose home support service may have been temporarily suspended and those clients of higher priority currently in receipt of home support services.
The HSE is in the process of restoring services, where capacity exists. In order to maximise the capacity available, consideration has to be given to balancing delivery of service against suspended clients, clients assessed and waiting on commencement of home support services and the continued requirement to meet the needs of higher priority clients currently in receipt of services.
Having regard to broader public finances, I am committed to prioritising continued investment in the home support services. COVID-19 has shown that these services are needed now, more than ever, to keep people safe and well in their own homes.
The level of funding available for the Department of Health in 2021, and future years, and the quantum of services to be provided by the HSE, including home support will be considered as part of the annual national Estimates and budgetary process and National Service Planning.
1194. Deputy Peadar Tóibín asked the Minister for Health the status of progress on the proposed transport support scheme that is due to replace the mobility allowance and the motorised transport grant, which both ceased to exist in February 2013; when the scheme will be finalised; if he plans to work with the Departments of Communications, Climate Action and Environment and Transport, Tourism and Sport to finalise the scheme; and if he will make a statement on the matter. [15494/20]
View answerTwo schemes, the Mobility Allowance and Motorised Transport Grant, were put in place in 1979 and 1968 respectively, for operation by the Health Service Executive (HSE) at a time when there was limited availability of accessible public transport. The Government decided to close these administrative schemes in 2013, on foot of the reports of the Ombudsman in 2011 and 2012 regarding the legal status of both Schemes in the context of the Equal Status Acts.
On foot of the 2013 recommendations of the Interdepartmental Group, which was chaired by the Department of An Taoiseach, the Government decided that the Minister for Health, in consultation with other relevant Ministers, would progress preparatory work for a new statutory scheme to provide individual payments to people with severe disabilities who require additional income to address the costs of their mobility needs. The Interdepartmental Group met eight times between June and September that year.
In 2013, the Government also decided to continue payment of the monthly Mobility Allowance on an interim basis, to those who were in receipt of the Mobility Allowance at the time that the Scheme closed. Of the 4,700 individuals in receipt of the Mobility Allowance (€9 million per annum) when the Scheme closed in 2013, there were 3,831 people in receipt of the interim payments at July 2019.
Other transport supports available to persons with disabilities in the State include the Disabled Drivers and Disabled Passengers scheme, operated by the Revenue Commissioners; the Free Travel Scheme operated by the Department of Employment Affairs and Social Protection; and CLÁR funding, approved by the then Minister for Rural and Community Development, to voluntary organisations providing transport for people with significant mobility issues.
At the whole of Government level, the National Disability Inclusion Strategy 2017-2021 sets the overall framework for the equal participation of people with disabilities in society. Monitoring of the implementation of the Strategy is being overseen by the National Disability Inclusion Strategy Steering Group which comprises key Government Departments, the National Disability Authority and the Disability Stakeholders Group.
Under the Strategy, the Department of Transport, Tourism and Sport has responsibility for the continued development of accessibility and availability of accessible public transport and is committed to the continued development of accessible public transport in recognition of the importance of such services to the lives of people with disabilities.
Recent developments which will impact on policy options regarding the provision of transport supports for people with a disability include the following:
The ongoing progress by the Department of Transport, Tourism and Sport in providing accessible public transport nationally and that Department's public consultation launched on 14 November last, to review active travel and public transport policy, including accessible public transport;
The Cost of Disability Study currently underway which was commissioned by the Department of Employment Affairs and Social Protection as part of Budget 2019. The research, when complete, will inform policy direction in relation to the provision of adequate supports to meet the needs of people with disabilities, including transport costs; and
The Working Group established under Action 104 of the National Disability Inclusion Strategy by the Department of Justice and Equality which states that:- "We will lead a review of transport supports encompassing all Government funded transport and mobility schemes for people with disabilities, to enhance the options for transport to work or employment supports for people with disabilities and will develop proposals for development of a coordinated plan for such provision. This plan will have regard to making the most efficient use of available transport resources.”
1195. Deputy Peadar Tóibín asked the Minister for Health the number of active pathologists in light of the fact that there has been a shortage of pathologists in some regions, with post-mortem procedures taking up to five days in some counties; if there was planning for an increased demand on pathologists due to Covid-19; if there is provision for increased counselling and bereavement services for families due to secondary trauma arising from deaths due to Covid-19 and the delay in carrying out post-mortems; and if he will make a statement on the matter. [15498/20]
View answerThere are currently 270 Consultant Histopathologists employed across the HSE.
In preparation for the impact of COVID-19, my Department worked with the Department of Housing, Planning and Local Government which established a COVID-19 Excess Mortality National Oversight Group. A plan was developed by this inter-agency group to guide the implementation of an effective and appropriate national system for managing mortality, informed by the need for compassion and care for the families affected.
Key membership of this group included the HSE, the Office of the State Pathologist, the Coroner Service and the Faculty of Pathology, to ensure issues arising with post-mortem and funeral services were addressed to minimise the impact of deaths on families.
My Department and the HSE worked with the Department of Justice and the Coroner Service to minimise any delays for families associated with post-mortem requirements. Following these discussions, the HSE advise that there has been a significant reduction in delays associated with post-mortems in hospitals.
The HSE put in place a range of additional initiatives across hospitals to ensure end of life care in response to COVID-19. This included developing special visiting passes for relatives to visit dying family members, enabling virtual visiting services and ensuring access to appropriate chaplaincy support for patients.
The HSE is co-ordinating a comprehensive psychosocial response to address the impact of the coronavirus pandemic and to support the overall wellbeing, resilience and mental health of our population.
To provide additional bereavement support, the HSE in conjunction with Irish Hospice Foundation has established a National Bereavement Support Line which is operational 5 days a week. Information on this line has been made available through a variety of channels including radio adverts, HSE and IHF websites and distributed to all hospitals, nursing homes and long stay facilities.
1196. Deputy Sean Fleming asked the Minister for Health the position regarding and status of a property (details supplied); and if he will make a statement on the matter. [15500/20]
View answerAs the Health Service Executive is responsible for the management of the public healthcare property estate, I have asked the HSE to respond directly to you in relation to this matter.
1197. Deputy Imelda Munster asked the Minister for Health his plans and timelines prepared to ensure that day services for adults with disabilities can resume on a full-time basis, in view of the caring burden that closures and reduced hours have placed on parents and families that must now return to work as the economy reopens; and if he will make a statement on the matter. [15505/20]
View answerAs part of the overall effort to contain the spread of COVID-19 and in line with public health advice, day service locations closed in March.
Since then, HSE Disability Services have been working to develop national guidance on the part of the disability sector to direct how all day services can be delivered. The Guidance to support the Framework for the Resumption of Adult Disability Day Services was published by the HSE on 9 July 2020.
In developing the guidance document to guide providers, the HSE worked closely with service providers through representative organisations such as the National Federation of Voluntary Service Providers, Disability Federation of Ireland and the Not for Profit Association, in addition to Inclusion Ireland, who represent people with intellectual disabilities and their families.
The guidance document seeks to support the safe return of services in the context of ongoing public health guidance. It also recognises that the impact of public health guidance will result in services being provided at a reduced level and will require changes in how people are supported, increased use of technology where appropriate and more use of outreach supports.
Day services will gradually resume during the month of August. Service providers are already working to get day services ready to reopen safely, and in line with public health guidance. Service providers will be in touch with all families and service users during the month of July to discuss when they may expect the resumption of their service and what that service will consist of.
I want to acknowledge the many challenges experienced by individuals and their families over this difficult time. Families across the country have had their routines upended due to the impact of COVID-19 and I hope that this will be the first step towards returning to some sense of normalcy.
The Guidance to support the Framework for Resumption of Adult Disability Day Services is available on the New Directions website: www.hse.ie/newdirections. The HSE have also issued monthly communications updates for service users and their families, the latest leaflet “Adult Disability Day Services and COVID-19 - What’s Happening? July 2020” is available at the above link.
