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Tuesday, 14 Jul 2020

Written Answers Nos. 1248-1272

Disability Services Provision

Questions (1248)

Marian Harkin

Question:

1248. Deputy Marian Harkin asked the Minister for Health when adult disability day services will reopen for those that urgently require these services in order that they do not regress further; if there will be a reduction in day services; when parents will be notified (details supplied); and if he will make a statement on the matter. [15639/20]

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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 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.

National Children's Hospital

Questions (1249)

David Cullinane

Question:

1249. Deputy David Cullinane asked the Minister for Health the works underway at the national children’s hospital; if none, when they will resume; and if he will make a statement on the matter. [15640/20]

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Written answers

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.

Medical Cards

Questions (1250, 1251)

David Cullinane

Question:

1250. Deputy David Cullinane asked the Minister for Health if his attention has been drawn to situations in which persons in hospital who are being referred to general practitioners for blood tests are being charged accordingly; and if he will make a statement on the matter. [15641/20]

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David Cullinane

Question:

1251. Deputy David Cullinane asked the Minister for Health if his attention has been drawn to situations in which persons in hospital with medical cards who are being referred to general practitioners for blood tests are being charged accordingly; and if he will make a statement on the matter. [15642/20]

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Written answers

I propose to take Questions Nos. 1250 and 1251 together.

In response to the Covid-19 pandemic, hospital appointments and procedures were restricted as a public safety measure. The availability of appointments as well as visitor restrictions may vary between hospitals. Non-COVID services are now starting back gradually.

People who do not hold a medical card or GP visit card access GP services, including phlebotomy services, on a private basis. The fees charged by individual GPs for private consultations are a matter of private contract between clinicians and their patients.

Persons who are eligible for GP care without charge under the Health Act 1970 are not subject to any co-payments or other charges in respect of such services. There is no provision under the GMS GP contract for medical card or GP visit card holders to be charged for routine phlebotomy services provided by their GP which are required to either assist in the diagnosis of illness or the treatment of a condition and the HSE has advised GPs accordingly.

I am aware that, nonetheless, some GPs are charging GMS patients for phlebotomy services in some circumstances. The GP chronic disease management programme which is being phased in from this year will involve the ongoing monitoring of patients’ condition and any blood tests required in this context will be covered by the fees payable for this care.

However, it remains a matter of concern to me that a medical card or GP visit card patient might be charged for blood tests which are clinically necessary and I have asked my officials to discuss with the HSE what further solutions to this issue may be possible. If such a patient believes he or she has been incorrectly charged for routine phlebotomy services by his or her GP, then that patient should report the matter to their HSE Local Health Office.

National Treatment Purchase Fund

Questions (1252)

Niall Collins

Question:

1252. Deputy Niall Collins asked the Minister for Health when a person (details supplied) will be assessed for surgery under the National Treatment Purchase Fund; and if he will make a statement on the matter. [15660/20]

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Written answers

In response to the Covid-19 pandemic the HSE had to take measures to pause most elective scheduled care activity with effect from the end March 2020. 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 National Public Health Emergency Team (NPHET) and in accordance with World Health Organisation guidelines, and the National Action Plan.

To ensure services are re-introduced in a safe, clinically-aligned and prioritised way, the HSE launched its Strategic Framework for ‘Service Continuity in a Covid Environment’ on 24th June 2020. Its implementation will ensure service resumption is done in an integrated way. This will involve a phased approach to ensure community services are strengthened. The Framework will also consolidate new ways of working and build on international knowledge. The HSE is currently developing a Service Continuity Roadmap for the resumption of services across the health system. My Department, the HSE and the National Treatment Purchase Fund are currently working together to evaluate the impact of Covid 19 on Scheduled Care waiting lists, in order to be prepared to address pent up demand.

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 is a standardised approach used by the HSE to manage scheduled care treatment for in-patient, day case and planned procedures. It sets out the processes that hospitals are to implement to manage waiting lists and was developed in 2014 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.

In relation to the particular query raised, as this is a service matter, I have asked the HSE to respond to the Deputy directly.

Long-Term Illness Scheme

Questions (1253)

Niall Collins

Question:

1253. Deputy Niall Collins asked the Minister for Health if a device (details supplied) will be CE approved and available here under the long-term illness scheme; and if he will make a statement on the matter. [15677/20]

View answer

Written answers

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

Primary Care Centres

Questions (1254)

Seán Sherlock

Question:

1254. Deputy Sean Sherlock asked the Minister for Health the status of works and costs involved for a project (details supplied). [15678/20]

View answer

Written 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.

Covid-19 Pandemic

Questions (1255)

Johnny Mythen

Question:

1255. Deputy Johnny Mythen asked the Minister for Health if new Covid-19 guidelines will be sought regarding old folks' homes and residential care centres (details supplied); and if he will make a statement on the matter. [15679/20]

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Written answers

It is recognised that the impact of COVID-19 on society in general and especially those living in long term residential care facilities has been considerable. Residential settings are people’s homes as well as places where health and social care are provided. The introduction of physical distancing, isolation and restricted contact with family and loved ones has changed the usual dynamic of social interaction. During these times there has been a particular emphasis on retaining a holistic view of the wellbeing of residents, remaining person-centred, being cognisant of their rights as citizens, and being vigilant that in seeking to shield them from infection that these rights are not infringed upon in to an extent, or in a manner, that is disproportionate.

However, it is important to recall that people living in long-term residential care (LTRC) facilities are particularly vulnerable populations in the context of Covid-19 and have been identified by the World Health Organisation (WHO) to be at a higher risk of being susceptible to infection from this disease and for subsequent adverse outcomes.

The actions and measures we have taken in Ireland to support long term residential care facilities and their residents have evolved on foot of epidemiological data and guidance from the WHO and the European Centre for Disease Prevention and Control (ECDC). These measures have been both society wide as well as focused specifically on residential facilities. Advice from the National Public Health Emergency Team (NPHET) focused on all LTRC settings and its recommended actions were relevant for all residential care services - older people, disability and mental health settings.

As the disease is becoming more suppressed in the community the National Public Health Emergency has advised that the gradual reintroduction of usual activities while taking public health precautions should commence. This advice is reflected in the latest Cocooning and visiting guidance. Detail of this guidance is set out by the Health Protection Surveillance Centre at: https://www.hpsc.ie.

The Department of Health is very much aware of how difficult the current restrictions on visiting are for residents and their families. Families are encouraged to talk to the support staff at the person’s residence, to make arrangements for visits and other activities that can be facilitated within the current public health guidance. While it is appropriate in line with the public health cocooning guidance for activities outside the home to commence, it is important to balance the risk involved in prolonged periods of time outside the home. These risks will continue to be reviewed in line with the disease progression and guidelines will be updated.

Medical Waste Disposal

Questions (1256)

Catherine Connolly

Question:

1256. Deputy Catherine Connolly asked the Minister for Health his plans to introduce a national scheme for the proper disposal and or recycling of unused medicines; and if he will make a statement on the matter. [15694/20]

View answer

Written answers

The HSE have never organised a national 'Disposal of Unused Medicines Properly' campaign through Community Pharmacies.

As with any proposal that would have an impact on HSE expenditure, it would require it to be carefully considered in the context of available resources and scoped appropriately.

The HSE would anticipate that any future discussions with the Irish Pharmacy Union in relation to a nationwide approach to better medication management, would include appropriate disposal arrangements for unused medicines.

Health Screening Programmes

Questions (1257)

Matt Carthy

Question:

1257. Deputy Matt Carthy asked the Minister for Health if those women who donate breast milk for use by the health services are now required to undertake a blood test; if the cost of such blood tests are or will covered by the HSE; and if he will make a statement on the matter. [15702/20]

View answer

Written answers

As the question relates to service matters, it has been referred to the HSE for direct reply.

Emergency Departments

Questions (1258)

Matt Carthy

Question:

1258. Deputy Matt Carthy asked the Minister for Health if he will commission an examination into the potential for restoring accident and emergency services at Monaghan hospital in view of the pressures evident at Cavan and Drogheda, particularly with Covid-19 restrictions remaining in place; and if he will make a statement on the matter. [15703/20]

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Written answers

Monaghan Hospital and Cavan General Hospital operate as a single entity, with an integrated managerial and clinical governance system, care pathways and support functions. The Emergency Department is located at Cavan General Hospital, while the facilities at Monaghan Hospital are focused on elective care and the streaming of appropriate patients to the Minor Injuries Unit located on site.

Monaghan Hospital also continues to provide Theatre, Day Services, Diagnostic Services, Ambulatory Care and Out-Patient Services.

Covid-19 Pandemic

Questions (1259)

Matt Carthy

Question:

1259. Deputy Matt Carthy asked the Minister for Health if consideration has been given to appointing a representative from the Mental Health Commission onto the National Public Health Emergency Team expert group; and if he will make a statement on the matter. [15704/20]

View answer

Written answers

As the Deputy is no doubt aware, the NPHET for COVID-19 is accountable to me as Minister for Health and is made up of senior public officials of the Department of Health and a number of relevant State Agencies, in addition to highly qualified subject matter experts from disciplines such as virology, infectious diseases, intensive care etc. who are among the leading practitioners in their fields in this country.

The NPHET can add to its membership on the basis of the additional expertise or support it identifies as being required so as to ensure that it is in the best possible position to provide advice and recommendations for consideration by the Minister for Health and the Government. These are the criteria on which the NPHET identifies the requirement for particular expertise. This flexibility in approach to selection is necessary for a group such as this in the context of an international public health crisis of the kind we are currently experiencing due to the pandemic, and gives effect to Ireland’s obligations to the WHO.

The NPHET established the NPHET Vulnerable Peoples Subgroup, which has broad membership from across Government Departments, Agencies and key stakeholders. The Subgroup was established to provide oversight and assurance with regard to the specific preparedness, measures and actions that need to be taken to protect vulnerable groups and individuals in society. The Subgroup includes a representative of the Mental Health Commission and ensures that the interests of people with mental health issues continue to be upheld during the COVID-19 emergency.

Medical Cards

Questions (1260)

Paul McAuliffe

Question:

1260. Deputy Paul McAuliffe asked the Minister for Health if a medical card application by a person (details supplied) will be reviewed. [15730/20]

View answer

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.

Medical Waste Disposal

Questions (1261, 1292)

Johnny Mythen

Question:

1261. Deputy Johnny Mythen asked the Minister for Health if he will introduce a disposal of unused medicines properly, DUMP, scheme through local pharmacies (details supplied); and if he will make a statement on the matter. [15733/20]

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Colm Burke

Question:

1292. Deputy Colm Burke asked the Minister for Health if he will arrange for the HSE to put in place a national medicines recycling programme known as DUMP in accordance with the proposal made by a union (details supplied); and if he will make a statement on the matter. [15941/20]

View answer

Written answers

I propose to take Questions Nos. 1261 and 1292 together.

The HSE have never organised a national 'Disposal of Unused Medicines Properly' campaign through Community Pharmacies.

As with any proposal that would have an impact on HSE expenditure, it would require it to be carefully considered in the context of available resources and scoped appropriately.

The HSE would anticipate that any future discussions with the Irish Pharmacy Union in relation to a nationwide approach to better medication management, would include appropriate disposal arrangements for unused medicines.

Covid-19 Pandemic

Questions (1262)

James O'Connor

Question:

1262. Deputy James O'Connor asked the Minister for Health the status of reopening of private parks that contain playgrounds and other children and family play areas; the person or body that has the ultimate responsibility to ensure social distancing is adhered to in such incidences once reopened (details supplied); and if he will make a statement on the matter. [15734/20]

View answer

Written answers

Since the Government confirmed the move to Phase 3 of the Roadmap for Reopening Society & Business from Monday 29 June 2020, all remaining cultural, community, religious, social and sporting amenities and events were permitted to reopen. Public health information and advice about the lifting of these restrictions as part of Phase 3 along with the measures that are now in place are available on the Government website at https://www.gov.ie/en/publication/d06271-easing-the-covid-19-restrictions-on-29-june-phase-3/.

As Minister for Health, I have no function in relation to the reopening of private parks as referred to by the Deputy or any other such private facilities.

The latest public health advice and guidance on Covid-19 related issues, including social distancing is available at the following link: https://www2.hse.ie/coronavirus/

Covid-19 Tests

Questions (1263)

Seán Crowe

Question:

1263. Deputy Seán Crowe asked the Minister for Health if his attention has been drawn to the fact that private hospitals are charging as much as €275 for Covid-19 testing before patients can access treatment; if this will be the case for patients referred under the NTPF; his views on whether this is appropriate in view of the fact that while these hospitals were in public hands patients were not previously charged for tests; his plans to cover the costs for testing for patients; and if he will make a statement on the matter. [15779/20]

View answer

Written answers

As the Deputy will be aware, I do not have any responsibility for private hospitals, including in relation to charges that they apply.

An arrangement was agreed with the private hospitals earlier in the year to use their facilities as part of the public system on a temporary basis, to provide essential services in anticipation of additional demand on public hospital services. Under the arrangement, all patients in private hospitals were treated as public patients while the agreement was in place. On review, the Government decided that the existing arrangement should not be extended beyond the end of June, and on 1st July 2020 all private hospitals reverted to private activity. The Department of Health does not have a role in the operational functions of private hospitals.

More broadly in relation to testing, the HSE has developed guidance for the management of planned hospital admissions for non-COVID care which sets out advisory testing strategies for hospital patients. This guidance seeks to provide an advisory framework for mitigating risks associated with the delivery of non-COVID care while COVID-19 continues to be prevalent, and testing provides one of a number of measures that can be taken to reduce risk.

As with any procedure or test, there will be a cost. I am not in a position to comment on what the actual cost may be in private hospitals, however, I understand that the costs arising from testing for COVID-19 in public hospitals is much lower than the upper charges quoted by the Deputy.

In addition, I can confirm that the NTPF have advised my Department that no patient is liable for any charge from a private hospital for services arranged by the NTPF.

Hospital Waiting Lists

Questions (1264)

Paul Donnelly

Question:

1264. Deputy Paul Donnelly asked the Minister for Health if a date for surgery will be provided for a person (details supplied). [15825/20]

View answer

Written answers

In response to the Covid-19 pandemic the HSE had to take measures to pause most elective scheduled care activity with effect from the end March 2020. 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 National Public Health Emergency Team (NPHET) and in accordance with World Health Organisation guidelines, and the National Action Plan.

To ensure services are re-introduced in a safe, clinically-aligned and prioritised way, the HSE launched its Strategic Framework for ‘Service Continuity in a Covid Environment’ on 24th June 2020. Its implementation will ensure service resumption is done in an integrated way. This will involve a phased approach to ensure community services are strengthened. The Framework will also consolidate new ways of working and build on international knowledge. The HSE is currently developing a Service Continuity Roadmap for the resumption of services across the health system. My Department, the HSE and the National Treatment Purchase Fund are currently working together to evaluate the impact of Covid 19 on Scheduled Care waiting lists, in order to be prepared to address pent up demand.

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 is a standardised approach used by the HSE to manage scheduled care treatment for in-patient, day case and planned procedures. It sets out the processes that hospitals are to implement to manage waiting lists and was developed in 2014 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.

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 Waiting Lists

Questions (1265)

Cian O'Callaghan

Question:

1265. Deputy Cian O'Callaghan asked the Minister for Health if Beaumont Hospital has an internal waiting list to access a HSE diabetes pump application form; if patients have to wait for extended periods before the hospital submits the applications to the HSE; the reason for the internal application form waiting lists and submission delays; and if he will make a statement on the matter. [15839/20]

View answer

Written answers

As the matter raised by the Deputy is a service delivery matter, I have referred the question to the HSE for direct reply.

Home Help Service

Questions (1266)

Brendan Smith

Question:

1266. Deputy Brendan Smith asked the Minister for Health if additional financial resources will be provided for home support in 2020 in view of the delays in providing these essential supports for many eligible patients; and if he will make a statement on the matter. [15849/20]

View answer

Written answers

The HSE provides a range of assisted living services including Personal Assistant (PA) and Home Support services to support individuals to maximise their capacity to live full and independent lives. These are related but separate services and each is funded separately. While the resources for the provision of assisted living services available are substantial they are finite. The 2020 national service plan allocated €1m additional funding to PA services.

PA and Home Support Services are provided either directly by the HSE or through a range of voluntary service providers. The majority of specialised disability provision (80%) is delivered through non-statutory sector service providers.

The presence and threat of COVID-19 in Ireland has resulted in significant challenges for service providers, families and most importantly, people with disabilities. During these challenging times disability services such as residential services, day services, home supports, Personal Assistant supports, respite services and children’s services were either suspended or delivered in alternative ways following Public Health guidance. The changes in service delivery have resulted in significant stressors being placed on families and individuals with disabilities across Ireland. In times of such uncertainty it was imperative that the vulnerable members of our community remained supported by our service providers, therefore, it was essential that a shift in focus occurred in terms of how services were delivered.

One of the primary opportunities which has occurred as a result of the presence of COVID-19 has been that the pandemic has acted as a catalyst to the development of alternative models of service delivery . It is from this position that the reshaping process of services occur and consideration is given to how services will now be best delivered, mindful of the assessed individualised needs and wishes of people with disabilities and in accordance with Government Public Health guidelines. During this planning phase, there is a need to engage with individuals and, as appropriate, with their families, in reshaping what people with disabilities choose that their day should look like in order to have a meaningful life.

The Department of Health and HSE have agreed that the provision of Home Support services should be prioritised in order to maintain and support people to continue to live in their own homes and to provide support and help families and carers.

Considerations for reshaping Home Supports are as follows; Where home support hours were reduced due to COVID-19 public health requirements, a rigorous assessment of need including a risk assessment of infection control issues, must occur to determine what reshaping of supports should be delivered. Where a reassessment determines hours should be re-instated and can be delivered in accordance with public health guidance, this should occur. Where a reassessment determines hours are not to be reinstated for whatever reason, a meaningful conversation should be held with the individual and where appropriate with family, to identify what supports are most appropriate and what has been learned during the COVID-19 restrictions in terms of changing needs and wishes, resilience etc.

The Disability Sector is re-establishing a number of structures, as well as other operational structures, that will co-ordinate and support the sector as we continue to navigate this pandemic and make every effort to deliver home supports in line with Public Health Guidance.

Covid-19 Pandemic

Questions (1267)

Gary Gannon

Question:

1267. Deputy Gary Gannon asked the Minister for Health if downloads for the newly launched Covid-19 tracker application on phone models below iPhone 6S or Android 7 count towards total downloads. [15856/20]

View answer

Written answers

The Covid Tracker app uses the Exposure Notification System developed by Apple and Google to exchange anonymous IDs between phones. This update has been provided by Apple and Google to iPhone 6s and newer models and Android 6.0 devices. Google are working to make ENS available on earlier Android phones. We estimate that at the moment the ENS is available to about 92% of smart phone users. The symptom Check-in and information function of the app works on all android and iOS phones.

Child and Adolescent Mental Health Services

Questions (1268)

Johnny Mythen

Question:

1268. Deputy Johnny Mythen asked the Minister for Health the number of children on the waiting list for CAMHS in County Wexford; and if he will make a statement on the matter. [15867/20]

View answer

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.

Child and Adolescent Mental Health Services

Questions (1269)

Johnny Mythen

Question:

1269. Deputy Johnny Mythen asked the Minister for Health the number of children waiting for a CAMHS appointment in County Wexford at the end of quarter one of 2019 and quarter one of 2020, respectively, in tabular form; and if he will make a statement on the matter. [15868/20]

View answer

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.

Child and Adolescent Mental Health Services

Questions (1270)

Johnny Mythen

Question:

1270. Deputy Johnny Mythen asked the Minister for Health the staffing levels in CAMHS in County Wexford by profession in each of the years 2018, 2019 and to date in 2020; and if he will make a statement on the matter. [15869/20]

View answer

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.

Child and Adolescent Mental Health Services

Questions (1271)

Johnny Mythen

Question:

1271. Deputy Johnny Mythen asked the Minister for Health if there are vacancies in staffing in CAMHS in County Wexford; the length of time these vacancies have been for; and if he will make a statement on the matter. [15870/20]

View answer

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.

Child and Adolescent Mental Health Services

Questions (1272)

Johnny Mythen

Question:

1272. Deputy Johnny Mythen asked the Minister for Health if the CAMHS in County Wexford is operating at a seven days a week model; if not, when a seven day a week service is planned to be operational; and if he will make a statement on the matter. [15871/20]

View answer

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.

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