Written Answers Nos. 1021-1046
1021. Deputy Niamh Smyth asked the Minister for Health the status of an appointment for a person (details supplied); if an appointment will be scheduled as soon as possible; and if he will make a statement on the matter. [14823/20]
View answerIn 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.
1022. Deputy Chris Andrews asked the Minister for Health the official figures for autism in an area (details supplied); and the breakdown by age of the figures. [14837/20]
View answer1023. Deputy Chris Andrews asked the Minister for Health the number of children with autism living in Dublin 2, 4, 6, 6W and 8. [14838/20]
View answerI propose to take Questions Nos. 1022 and 1023 together.
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.
1024. Deputy Colm Burke asked the Minister for Health the expected start date for development of a new elective hospital in Cork city; the possible locations of same; and if he will make a statement on the matter. [14840/20]
View answerAs you will recall, the National Development Plan stated that, “New dedicated ambulatory elective only hospital facilities will be introduced in Dublin Galway and Cork. These facilities will provide high volume, low complexity procedures on a day and outpatient basis, together with a range of ambulatory diagnostic services. The high volume of demand for such services in these major urban centres is sufficient to justify the construction of dedicated ambulatory centres.”
The elective hospitals oversight group has completed a Catchment Area Analysis within Dublin, Cork and Galway, within a national capacity context, but also within the catchments defined by the proposed Regional Health Areas, aimed at selected scopes of service.
The Elective Hospitals Oversight Group 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. This is due to be complete in the Autumn of 2020.
1025. Deputy Peter Fitzpatrick asked the Minister for Health his views on the fact that many dentists are refusing to see medical card holders and are only providing treatment to private patients, which is leaving the most financially venerable constituents without vital dental care; and if he will make a statement on the matter. [14850/20]
View answerI am concerned about reports that some medical card holders have been refused access to treatment by a small number of dentists who hold Dental Treatment Service Scheme (DTSS) contracts, following the easing of COVID-19 restrictions in May which enabled the return to routine care.
My Department has received reassurance from the HSE that any patients who have been refused care in a DTSS contracted service have been accommodated either in an alternative DTSS practice and/or directly by the HSE.
I would expect due process to be followed in respect of any withdrawal from the terms of a DTSS contract, in particular regarding an appropriate period of notice. I would also expect dentists to continue to honour their ethical and contractual obligations to patients during the notice withdrawal period, to either provide a service or to ensure that patients are referred to another dentist who will provide a service.
1026. Deputy Seán Haughey asked the Minister for Health if the 50-person restriction for indoor gatherings refers to the whole building in the case of a gym regardless of its size; if the size of the area in the building can be taken into account; and if he will make a statement on the matter. [14854/20]
View answerSince 29 June, as part of Phase 3 of the Roadmap to Reopening Society and Business, gyms are permitted to open. Gym owners/operators are advised to consult the public health advice which can be found on the government website at https://www.gov.ie/en/publication/cf9b0d-new-public-health-measures-effective-now-to-prevent-further-spread-o/#cultural-social-and-sport-measures. The measures that are recommended include that those responsible for reopening these facilities carry out a risk assessment before reopening to manage the public health risk for their customers, attendees, participants, and staff. The assessment should consider the risk factors for getting COVID-19, that is Distance, Activity, Time and Environment, and include controls such as managed entry, improved hygiene facilities, and regular cleaning to limit these. Facilities that reopen should observe physical distancing guidelines and apply the public health checklist to their operation. Furthermore, facilities reopening with a return of staff should apply the Return to Work Safely Protocol (see https://www.gov.ie/en/publication/22829a-return-to-work-safely-protocol/). This has been designed to support employers and workers to put measures in place that will prevent the spread of COVID-19 in the workplace.
Regulation 5 of the Health Act 1947 (Section 31A – Temporary Restrictions) (Covid-19) (No. 3) Regulations 2020 (S.I. No. 234 of 2020) provides that a person shall not organise, or cause to be organised, an indoor event (a gathering of persons) for cultural, entertainment, recreational, sporting, social, community or educational reasons other than where the maximum number of persons attending, or proposed to attend, the indoor event (for whatever reason) does not exceed 50 persons.
People separately planning to attend a gym would not constitute an “event” or “gathering.”
1027. Deputy Catherine Murphy asked the Minister for Health the authority responsible for the collection of public health passenger locator forms in view of the agreement with the Department of Justice and Equality on a temporary administrative basis to undertake same on behalf of the health authorities, an arrangement that ceased at the end of June 2020; the number of staff assigned to it; the way in which the handover was conducted; and if he will make a statement on the matter. [14855/20]
View answerThe Department of Justice continues to collect COVID-19 passenger locator forms at points of entry into the State.
1028. Deputy Louise O'Reilly asked the Minister for Health if the national maternity hospital, Holles Street, has received a new scanning machine for mesh implants; and if staff have received training on the way to use it. [14858/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.
1029. Deputy Alan Kelly asked the Minister for Health if he will guarantee that no patient will have to wait more than six months for health treatments here; and if so, the date he expects to be able to deliver this. [14860/20]
View answer1030. Deputy Alan Kelly asked the Minister for Health the amount he plans to spend on the National Treatment Purchase Fund, NTPF, in 2020. [14861/20]
View answerI propose to take Questions Nos. 1029 and 1030 together.
Budget 2020 included an increase in funding for the National Treatment Purchase Fund. This saw the funding of the NTPF increase by €25million to €100million. The year-on-year increases to the National Treatment Purchase Fund since Budget 2017 reflect the Government’s priority to improve waiting times for patients to access hospital treatment.
It was the expectation of the Department that the majority (€69million) of the NTPF funding allocation for 2020 would be expended broadly in line with 2019 levels of activity vis-à-vis IPDC, OPD and GI Endoscopy initiatives. In addition, in 2020, the NTPF would further expand its list of targeted inpatient and day case procedures to support further significant reductions in wait times, with a particular focus on improving access to hospital outpatient services. This would include arranging full care for patients on the outpatient waiting lists, to include the surgery or treatment where required.
A key focus in 2020 was the development of sustainable solutions to tackle waiting lists, in line with the objectives of Sláintecare. In this regard, it was the intention that the additional €25million of the NTPF Budget allocation for 2020 would be used to examine new and innovative solutions.
In response to the Covid-19 pandemic the HSE had to take measures to pause all non-urgent 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.
At the end of March, the NTPF advised the Department that in line with the National Action Plan on COVID-19, it was temporarily ceasing the commissioning of both Inpatient / Day case procedures (including GI scopes) and Outpatient appointments. This temporary cessation applied to both insourced and outsourced commissioning.
The National Public Health Emergency Team (NPHET) has since revised its recommendation on the pausing of all non-essential health services, with a recommendation that the delivery of acute care be determined by appropriate clinical and operational decision making. Application of the essential risk mitigating steps set out in the guidance developed under the auspices of the NPHET Expert Advisory group will have operational implications, which will impact on throughput.
With the increase in elective care activity, the NTPF's Commissioning Team is now working with HSE Hospital Groups and Private Hospitals to establish available capacity for insourcing and outsourcing initiatives from July onwards. Due to the ongoing emergency, the available capacity of the health system, both private and public, is currently being reviewed and it is not yet possible to estimate how much activity will be available for procurement. The Department and the NTPF will engage with each other in order to assess the potential for the NTPF to use its full allocation to purchase additional hospital treatments. In doing so, the NTPF will consider the entire health system, outside of the traditional NTPF areas, including diagnostics and beds.
1031. Deputy Alan Kelly asked the Minister for Health the number of extra hospital public beds he expects to deliver in each of the years 2020 to 2024. [14862/20]
View answerThe Programme for Government, Our Shared Future, commits to continuing investment in our health care services in line with the recommendations of the Health Service Capacity Review and the commitments in Project Ireland 2040.
The Capacity Review found that the net requirement, in a reform scenario, is for an additional 2,590 hospital beds by 2031 (inpatient, day case, critical care) with an immediate requirement for 1,290 beds to address overcrowding and to ensure hospitals operated at 85% occupancy in line with other OECD countries. Approximately 770 additional beds have been provided to date. The National Development Plan provides for the addition of the full 2,590 beds by the earlier date of 2027.
The future opening of additional acute bed capacity will be considered in the context of the Estimates discussions for the years concerned 2020 and on the priorities in the HSE's National Service Plans for those years.
1032. Deputy Alan Kelly asked the Minister for Health the number of extra hospital consultants that will be hired in 2020. [14863/20]
View answerI have asked the HSE to reply directly to the Deputy on this matter.
1033. Deputy Alan Kelly asked the Minister for Health the number of extra nurses that will be hired in 2020. [14864/20]
View answerI have asked the HSE to respond directly to the Deputy on this matter.
1034. Deputy Alan Kelly asked the Minister for Health the service providers here for adults with intellectual disabilities; the date each service provider will reopen; and the percentage of services that each provider will open in tabular form. [14865/20]
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.
1035. Deputy Alan Kelly asked the Minister for Health the service providers here for children with intellectual disabilities; the date each service provider will reopen; and the percentage of services that each provider will open in tabular form. [14866/20]
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.
1036. Deputy Alan Kelly asked the Minister for Health the date on which a four-hour target will be applied to all emergency department waits. [14867/20]
View answerThe HSE National Service Plan (NSP) sets out the type and volume of health and personal social services that the HSE undertakes to provide within its financial allocation each year. The NSP 2020 sets targets in relation to the waiting times of attendees of emergency departments (ED) for discharge or admission including specific targets for patients over 75.
The waiting time targets as envisaged within the Oireachtas Sláintecare Report will continue to underpin the development of the Capacity-Access priority programme being delivered as part of Sláintecare, in ensuring that capacity is put in place to meet the clinical demands on the health system and to reduce waiting times for treatment.
1037. Deputy Alan Kelly asked the Minister for Health the percentage of overall health spending being devoted to the provision of primary care services under the current departmental spending Estimates. [14868/20]
View answerPrimary care incorporates a range of multi-disciplinary services delivered by GP's, community nursing and health and social care professionals. The services provided include physiotherapy, occupational therapy, speech and language therapy, paediatric homecare and community intervention teams.
The HSE’s Primary Care Reimbursement Service (PCRS) supports the delivery of a wide range of these primary care services to the general public through over 7,000 primary care contractors across a range of community health schemes. These schemes form the infrastructure through which the Irish Health System delivers a significant proportion of Primary Care to the public. It is through PCRS that GPs receive a range of fees and allowances under the GMS scheme, although it should be noted that the total PCRS budget includes a range of other payments, the largest proportion of which is accounted for by drugs and medicines for both GMS and non-GMS payments.
The figures below exclude expenditure on social care services and local demand led services.
|
2020 |
|
|
€M |
|
|
Primary Care |
927 |
|
*PCRS |
2,951 |
|
3,878 |
|
|
Overall Total Budget |
17,106 |
|
Primary Care share |
22.7% |
Note: The figures are as per the National Service Plan 2020. There was an additional €3m allocated to primary care for winter planning following publication of the NSP.
These figures have yet to be adjusted to take account of the funding provided to the Health Vote in relation to Covid 19.
* The PCRS figure excludes expenditure on local demand led services."
1038. Deputy Alan Kelly asked the Minister for Health when he will announce the construction locations and timelines for new elective hospitals that he plans to build. [14869/20]
View answerAs you will recall, the National Development Plan stated that, “New dedicated ambulatory elective only hospital facilities will be introduced in Dublin Galway and Cork. These facilities will provide high volume, low complexity procedures on a day and outpatient basis, together with a range of ambulatory diagnostic services. The high volume of demand for such services in these major urban centres is sufficient to justify the construction of dedicated ambulatory centres.”
The Elective Hospitals Oversight Group 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. This is due to be complete in the Autumn of 2020.
1039. Deputy Alan Kelly asked the Minister for Health if he accepts the findings of the de Buitléir report into private activity in public hospitals; and the timeline for its implementation. [14870/20]
View answerThe Sláintecare Report and the recommendations of the Report of the Independent Review Group established to examine Private Activity in Public Hospitals (“the de Buitléir Report”) each propose progression towards a strengthened public healthcare system, including through the phasing out of private activity from public hospitals. The current Programme for Government, Our Shared Future, contains specific commitments in relation to finalising the new Sláintecare consultant contract and legislating for public-only work in public hospitals, which are fundamental aspects of the Independent Review Group report necessary to support progression towards the goal of a single-tier public hospital system.
1040. Deputy Alan Kelly asked the Minister for Health the number of extra hours of home help he expects to fund in 2020; and the number of hours he is planning to deliver in 2021. [14871/20]
View answerThe Health Service Executive National Service Plan provides for 18.9 million home support hours to be delivered to 53,700 people and to provide a further 360,000 hours through intensive home care packages to 235 people.
COVID-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.
The level of funding available for the Department of Health in 2021 and the quantum of services to be provided by the HSE, including home support will be considered as part of the national Estimates and budgetary process and National Service Planning.
1041. Deputy Alan Kelly asked the Minister for Health if there is an emergency medicine consultant present on a 24-hour basis in each emergency department across all acute hospitals; and if not, when there will be. [14872/20]
View answerI have asked the HSE to respond to the Deputy directly on this matter.
1042. Deputy Alan Kelly asked the Minister for Health the date on which he plans to end pay inequality for hospital consultants. [14873/20]
View answer1183. Deputy David Cullinane asked the Minister for Health his views on pay equalisation for hospital consultants; the actions will he take to secure this; and if he will make a statement on the matter. [15481/20]
View answerI propose to take Questions Nos. 1042 and 1183 together.
At present 'new entrant' consultants recruited since 1 October 2012 are on lower pay scales than those recruited prior to that date.
The De Buitléir Group established to examine how to give effect to the Sláintecare recommendation on the removal of private practice from the public hospital system recommended the introduction of a Sláintecare 'public only' Contract going forward, with pay parity confined to consultants who would take up this contract. It specifically recommended that the contract be made available to any serving consultants who would choose to move to it in addition to all future recruits.
The Programme for Government provides for the finalisation of the new Sláintecare Consultant Contract and the introduction of related legislation to support 'public-only work' in public hospitals. The FEMPI Acts currently prohibit pay increases for serving public servants and will require amendment to enable pay increases for serving consultants who move to the Sláintecare 'public only' Consultant Contract.
It is my intention to commence engagement with the representative bodies in relation to this Programme for Government commitment as a matter of priority. It is through this engagement that all matters relating to consultants terms, conditions and additional supports will be considered.
1043. Deputy Alan Kelly asked the Minister for Health the extra funding he plans to provide for general practitioner services in 2020 and 2021. [14874/20]
View answerThe agreement reached between the Department of Health, the HSE, and the IMO on GP Contractual Reform and Service Development, finalised in May 2019, provided for phased increases in the rates of capitation and other allowances paid to GPs as well as for the introduction of new services, including the Chronic Disease Management Programme and supports for practices in areas of deprivation.
The additional cost of implementing the Agreement in 2019 was €27.3 million, with an additional €53 million required in 2020, bringing the total available funding for 2020 to over €80 million. A further funding requirement of €62.5 million is foreseen for 2021.
In addition to this, a package of measures to support general practice was introduced from 16 March last in order to take account of the impact of COVID on general practice and to ensure that GPs were in a position to provide essential COVID-19 and non-COVID-19 services. These measures included fees payable from 16 March for the provision of remote consultations, respiratory assessment clinics and extended opening hours. The cost of these supports to date is approximately €60 million and is expected to reach approximately €100 million by mid-August.
1044. Deputy Alan Kelly asked the Minister for Health when he plans to put in a place a new general practitioner contract. [14875/20]
View answerThe existing General Medical Scheme contract has been modernised to a large extent by the agreement reached in 2019 between the Department of Health, the HSE and the IMO on a major package of GP contractual reform and service developments.
The Agreement introduces fees for new services such as the chronic disease management programme and therapeutic phlebotomy for GMS patients with haemochromatosis. It provides for a 10% increase in the rural GP allowance, an increase in the allowance paid to dispensing GPs, and a targeted fund of €2 million to support practices in deprived urban areas. Maternity and paternity leave arrangements have been improved, in recognition of the need to ensure that general practice is compatible with doctors’ family commitments. A wide-ranging set of modernisation measures have also been agreed in the areas such as eHealth and medicines management. In return for cooperation with these service developments and reforms, investment in general practice will increase by approximately 40% (or €210 million) over four years. At the end of 2019 95% GMS GPs (2,374) had accepted the terms of the Agreement.
The Agreement also includes a commitment to undertake a strategic review of GP services within the lifetime of the Agreement, to examine how best to ensure the provision of GP services in Ireland for the future. The outcome of this review will inform future contractual changes. Preparatory work for the review is beginning this year.
1045. Deputy Alan Kelly asked the Minister for Health the way in which he will bring forward the reintroduction of all health screening programmes; and the changes he has made since he took up office in order to speed up the launch of such services that were announced under his predecessor. [14876/20]
View answerThe National Screening Service’s (NSS) population-based screening programmes BreastCheck, CervicalCheck, BowelScreen and Diabetic RetinaScreen were temporarily paused in March 2020 due to the COVID-19 pandemic.
These measures aligned with the National Public Health Emergency Team’s (NPHET) recommendations which have as their goal to minimise the spread of COVID 19. In making this decision, the health, wellbeing and safety of screening service users and staff is the priority for the NSS.
The Covid-19 pandemic has led to an unprecedented interruption to normal health services both in the community and acute hospitals. Since the COVID-19 pandemic started, the NSS has monitored the feasibility of restarting the four programmes.
As such, I am pleased to inform you that the phased resumption of the NSS population screening programmes has started as part of the HSE overall plan to resume its health services that had been paused due to the Covid-19 pandemic. CervicalCheck began sending invites and reminders to participants in its cervical screening programme on the 06 of July, Diabetic RetinaScreen will also resume screening in July. BreastCheck and BowelScreen will resume screening in September/October.
1046. Deputy Alan Kelly asked the Minister for Health the details of the catch-up programme he is introducing in relation to health screening. [14877/20]
View answerAs this is a service matter, it has been referred to the Health Service Executive for attention and direct reply to the Deputy.
