Tuesday, 21 Jul 2020

Written Answers Nos. 692-711

Ophthalmology Services

Questions (692)

David Cullinane

Question:

692. Deputy David Cullinane asked the Minister for Health his plans to support the expansion of community ophthalmology; and if he will make a statement on the matter. [16966/20]

Written answers

Minister for Health

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

National Children's Hospital

Questions (693)

David Cullinane

Question:

693. Deputy David Cullinane asked the Minister for Health if he has met the National Paediatric Hospital Development Board or representatives of the Board since he became Minister; and if he will make a statement on the matter. [16967/20]

Written answers

Minister for Health

I met with the Chair of the NPHDB and its Chief Officer on 10 July 2020 to discuss the new Children’s hospital project. During the meeting I emphasised the importance of the hospital and the need to complete it. I understand that the contractor issued a statement, also on 10 July, stating that it intended to resume work with effect from Monday 13 July. I am advised that the contractor has returned to site.

Palliative Care Services

Questions (694)

David Cullinane

Question:

694. Deputy David Cullinane asked the Minister for Health his plans to improve palliative care; and if he will make a statement on the matter. [16968/20]

Written answers

Minister for Health

Ireland’s national policy on palliative care for patients and families is contained in the 2001 Report of the National Advisory Committee on Palliative Care. The policy was developed at a time when specialist palliative care was at a relatively early stage of development in Ireland and emphasises the structures and staffing required for specialist palliative care services in hospices, acute hospitals and the community. Notwithstanding its longevity, our national policy on palliative care continues to be highly regarded internationally. The 2015 Quality of Death Index report by the Economist Intelligence Unit, which measures the current environment for end-of- life care services across 40 countries, ranked Ireland fourth in the world.

Demand for adult palliative care has greatly increased since 2001. Around 30,000 people in Ireland die each year. CSO mortality projections suggest there will be about 38,000 deaths in Ireland in 2031, rising to 54,000 per year by 2050. Due to our aging population and as more people with life-limiting illnesses live longer, our country faces the challenge of ensuring high quality palliative care is available to increasing numbers of people with life-limiting conditions, in all settings. Against this background, the Programme for Government commits to publish a new Palliative Care Policy for Adults by mid-2021 to update the 2001 policy.

In line with the Programme for Government, it is intended to open new hospices in Mayo, Waterford and Wicklow this year and expand an existing service in Kildare, which will see an additional 55 new beds coming on stream. In the coming years, the Government is committed to progressing the development of a further three hospices, in the midlands, Cavan and Drogheda. When these developments are in place, there will be a hospice serving every region in the country.

Ensuring children with life-limiting conditions can access palliative care services to help them have a good quality of life is very important to me as Minister for Health. In this regard, I welcome the commitment in the Programme for Government to increase resources for the Children’s Palliative Care Programme. This will be supported by consultants with a special interest in children’s palliative care and children’s outreach nurses to coordinate care for children with life-limiting conditions and their families.

Health Services Staff

Questions (695)

David Cullinane

Question:

695. Deputy David Cullinane asked the Minister for Health his plans to increase staffing in healthcare settings over the lifetime of the Government; and if he will make a statement on the matter. [16969/20]

Written answers

Minister for Health

The Programme for Government commits to finalising the Sláintecare Contract and increasing the number of ‘public-only’ consultants in our hospitals. The number of consultants has increased consistently in recent years and the Government is committed to continuing to increase consultant capacity.

As part of Budget 2020, in line with the continued rollout of the Sláintecare Implementation Plan, funding of €10 million in 2020 and €60 million in 2021 is being invested in the enhancement of Community Services. The additional full year funding will provide for up to 1,000 therapists, nurses, other health professionals in the community and the recruitment of dementia advisers.

This involves working towards the appointment of up to 1,000 additional staff across a range of disciplines and deploying these in teams that will focus in the first instance on managing older people with complex needs/chronic conditions and shifting care away from the acute hospitals.

The Department of Health issued a request to the HSE to provide a business case for the Enhanced Community Care Fund in late 2019 for the recruitment of the additional 1,000 staff, the services to which they would be assigned and the outcomes they will deliver.

An extensive document was submitted by the HSE shortly before the outbreak of COVID-19 in Ireland, setting out a model for a reformed approach to primary and community care. By agreement with HSE and Department of Health colleagues, the detailed response was issued in June 2020 to allow all focus to be appropriately placed on the COVID-19 pandemic emergency response. As we move towards service recovery, it is intended to finalise the Enhanced Community Care business case to ensure that recruitment of staff can be in place before year-end.

The programme for Government also commits to continue to implement the nursing agreement which includes measures to support recruitment and retention of nurses, including the Framework for Safe Nurse Staffing and Skill Mix. The Framework for Safe Nurse Staffing and Skill Mix in General and Specialist Medical and Surgical Care Settings in Adult Hospitals in Ireland is an evidence-based methodology to determine the nurse staffing and skill mix range required in our hospitals.

The Framework was developed in the Department of Health and piloted in three sites before it was formally launched by my colleague Minister Harris in April 2018. Results from the pilot were positive for both patients and staff, showing evidence of improvements in the quality of care and patient outcomes, and a reduction in length of stay. The Framework also stabilised the workforce, improving staff moral and leading to a reduction in agency spend.

The national rollout of the Framework for Safe Nurse Staffing and Skill Mix in General and Specialist Medical and Surgical Care Settings is now the responsibility of the HSE and a National Implementation structure has been agreed. Full national rollout has commenced and is starting in the model 4 hospitals.

For the most recent update we refer the deputy to HSE as they are responsible for the rollout of Phase 1. In relation to Phase 2 (emergency care setting), the pilot testing is ongoing with the first report due by the end of July. Once approved and published national roll out of this phase will begin, stabilising the workforce further. Phase 3 (non-acute care setting) is still in the early stages of development with the evidence review in progress.

Since the health service began managing the current pandemic several recruitment initiatives have taken place to maximise and support the workforce. However, it remains difficult to quantify the public health sector workforce requirements post Covid-19 while the impacts of the crisis on both staffing levels and resources are ongoing.

Although GPs are private contractors and not employed by the HSE, I am also concerned to ensure that the number of GPs will increase, and several efforts have been undertaken to this end. The yearly number of GPs entering training has increased steadily, rising from 120 in 2009 to 208 this year. The target for next year is 230 places. In addition, the 2019 GP Agreement for service modernisation and contractual reform will see the Government increase investment in general practice by approximately 40% (or €210 million) by 2023, increasing fees for participating GPs and improving maternity and paternity leave arrangements, making general practice more sustainable and a more attractive career option for doctors.

Rare Diseases Strategy

Questions (696)

David Cullinane

Question:

696. Deputy David Cullinane asked the Minister for Health when he will publish an updated National Rare Disease Plan; and if he will make a statement on the matter. [16970/20]

Written answers

Minister for Health

A National Rare Disease Plan for Ireland (2014 – 2018) was launched by the Minister for Health in July 2014. This is a generic policy framework for rare diseases. The scope of the plan is broad given that there are approximately 8,000 rare diseases affecting millions of EU citizens; and consequently, there can be a dearth of expertise and knowledge about some rare diseases, simply because they are so rare.

Many of the major recommendations of the plan have already been implemented including the establishment of a National Clinical Programme for Rare Diseases and a Rare Disease Office. Building on this progress to date, themes for inclusion in a roadmap for the coming period have been agreed with the Rare Disease Task Force, which comprises the main rare disease advocacy groups; Rare Disease Ireland, the Medical Research Charities Group (MRCP), and the Irish Platform for Patient Organisations, Science and Industry (IPPPOSI). The Rare Disease Plan is now firmly embedded in the work of the HSE Clinical Programme for Rare Diseases and the Rare Disease Office. This programme is now under the governance of the Office of the Chief Clinical Officer.

Meetings, to ensure that the input and the voice of the patient is represented in the continuing work ongoing in relation to Rare Diseases take place at regular intervals with the Rare Disease Task Force, the HSE National Clinical Programme for Rare Diseases and the Rare Disease Office.

A number of key themes have now been identified for progression in the coming period, including: Patient Awareness; European Reference Networks; Research & Registries; Access to Services; Access to Medicines; Diagnosis; Education & Training and Legislation & Policy. This will form the basis for work in this area in the time ahead.

Proposed Legislation

Questions (697)

David Cullinane

Question:

697. Deputy David Cullinane asked the Minister for Health his plans to enact the human tissue Bill; and if he will make a statement on the matter. [16971/20]

Written answers

Minister for Health

The Programme for Government includes a commitment to "Enact the Human Tissue Bill, providing the legal basis for an opt-out system of organ donation and deliver a public information campaign"

Work is progressing on the drafting of the Human Tissue (Transplantation, Post-Mortem, Anatomical Examination and Public Display) Bill in collaboration with the Office of Parliamentary Council.

Pre-Legislative Scrutiny of the General Scheme was undertaken by the Joint Committee on Health on 16 October 2019 and the Committee's report is awaited.

It is envisaged that the drafting process will be complete, and Government approval secured to publish the Bill, by the end of Quarter 4 2020. It is hoped that the Bill will then be progressed through the Houses of the Oireachtas.

National Maternity Strategy

Questions (698)

David Cullinane

Question:

698. Deputy David Cullinane asked the Minister for Health his plans to implement the National Maternity Strategy; and if he will make a statement on the matter. [16972/20]

Written answers

Minister for Health

Ireland's first National Maternity Strategy - Creating a Better Future Together 2016 - 2026 was published in January 2016. It represents a significant development in the delivery of national maternity policy that will fundamentally change how maternity care is delivered.

The National Women & Infants Health Programme was established in the HSE to lead the management, organisation and delivery of maternity, gynaecology and neonatal services across primary, community and acute care. As implementation of the Strategy is being driven by the Programme, I have asked the Health Service Executive to reply to you directly with the specific information requested.

Information and Communications Technology

Questions (699)

David Cullinane

Question:

699. Deputy David Cullinane asked the Minister for Health his plans to roll out eHealth and improve information and communications technology systems; and if he will make a statement on the matter. [16973/20]

Written answers

Minister for Health

eHealth encompasses a wide range of digital supports to health services and health workers across multiple health settings and services nationally. The value of eHealth became apparent during the COVID crisis, as technologies were quickly deployed at scale to remove the risk of a surge to acute hospitals, to support new pathways of care and to help reduce the risk of infection to clinicians and patients.

During the COVID-19 response, new eHealth solutions were deployed to provide secure electronic transfer of prescriptions from GP surgeries to pharmacies, reducing the risk of potential exposure for the public and health workers, by removing the need to attend surgeries for some prescriptions and reducing waiting times in community pharmacies.

The Deputy will be familiar with the smartphone Contact Tracing App which has been developed by the HSE, enhancing manual contact tracing, informing of the spread of Covid-19 symptoms nationally and providing a publicly trusted source of Covid-19 related news, information and guidance. The App runs on Apple and Android phones and has been developed in line with EU guidelines. Adoption of the app is entirely voluntary and the use of all functions is consent based. Within 48 hours over 1 million people had downloaded the app and signed up as registered users. Electronic transfer of prescriptions has proven hugely successful, very convenient and avoids the need for otherwise well patients to attend GP surgeries, reducing risk to them, GPs and practice staff. The depeloyment of telehealth solutions has been accelerated over the past three months and has emerged as a significant eHealth benefit in response to Covid. These are just a few of the eHealth digital supports that were introduced during the pandemic that will continue to be developed and improved with a view to embedding these technologies in healthcare settings.

A unique, individual health identifier (IHI) is required to enable clinical systems to communicate with each other, in the knowledge that they are dealing with the same patient and sharing of data across the various medical settings where patients seek treatment. In parallel with building on digital advances made during the COVID emergency, planned developments will include the roll-out of the IHI for health care facilities and healthcare practitioners, the embedding of Eircodes into healthcare systems and the implementation of an electronic health record for the new children's hospital which is currently at procurement stage.

Additionally, a continuing programme of work is in place by the HSE to upgrade and install ICT infrastructure in locations nationwide in multiple health settings.

Proposed Legislation

Questions (700)

David Cullinane

Question:

700. Deputy David Cullinane asked the Minister for Health if he plans to implement a patient safety Bill and mandatory open disclosure; and if he will make a statement on the matter. [16974/20]

Written answers

Minister for Health

The Patient Safety (Notifiable Patient Safety Incidents) Bill 2019 provides the legislative framework for a number of important patient safety issues, including: mandatory open disclosure of a list of notifiable patient safety incidents and the notification of same externally to the Health Information and Quality Authority, Chief Inspector of Social Services and the Mental Health Commission, as appropriate, to contribute to national learning and system-wide improvements. This mandatory requirement for open disclosure will ensure that patients and their families receive appropriate timely information in relation to an incident that may have occurred in relation to their care.

The Patient Safety (Notifiable Patient Safety Incidents) Bill 2019 will also bring the private hospitals within the remit of the Health Act 2007. The relevant provisions extend the remit of the Health Information and Quality Authority, allowing it to set standards for the operation of private hospitals, to monitor compliance with them and to undertake inspections and investigations as required. The Bill also contains provisions to support clinical audit within the health service.

The Bill was introduced into Dáil Éireann on the 12 December 2019 and passed Second Stage in the Dáil and is due to go to Dáil Committee Stage. The Bill is a Programme for Government commitment and it is my intention is to restore the Bill to the order paper. Following Dáil Committee stage, the Bill will be progressed to Dáil Report Stage and will then go through all Stages in the Seanad.

The Patient Safety (Notifiable Patient Safety Incidents) Bill 2019 is also part of the broader programme of legislative and policy initiatives to improve the ability of the health service to anticipate, identify, respond to patient safety issues and improve the quality and safety of health services for patients. Creating a culture of open disclosure and learning from the things that go wrong is the bedrock of making services safer.

Home Care Packages

Questions (701)

David Cullinane

Question:

701. Deputy David Cullinane asked the Minister for Health his plans to implement a statutory homecare scheme; and if he will make a statement on the matter. [16975/20]

Written answers

Minister of State at the Department of Health

A high-quality, consistent home-support service, focused on keeping people well in their homes and communities for as long as possible, is a key enabler to ensuring that people across a continuum of care get the right care, in the right place, at the right time. In this regard, my Department is in the process of developing a statutory scheme for the financing and regulation of home support.

As part of this, work is on-going to determine the optimal approach to the development of the scheme within the broader context of the Sláintecare reforms. Work undertaken in 2019 focussed on the design of the scheme, the options for regulation, and a review of existing services. In 2020, it had been intended to focus on piloting a reformed model of service delivery for home support services, the development of the evidence base for the financing of home support services; and the development of a framework for the regulation of these services.

While Sláintecare commits to the establishment of the scheme by the end of 2021, progress on the development of the scheme, including the planned testing of a pilot scheme in 2020, has been impacted by the ongoing work and diversion of resources as part of the response to COVID-19. However, my Department remains committed to bringing forward this work as a priority, taking on board the learning from the response to COVID-19, in order to support people to age well and continue to live independently in their homes for as long as possible.

Primary Care Centres

Questions (702)

David Cullinane

Question:

702. Deputy David Cullinane asked the Minister for Health his plans to deliver additional primary care centres; and if he will make a statement on the matter. [16977/20]

Written answers

Minister for Health

As the HSE has responsibility for the provision, along with the maintenance and operation of Primary Care Centres and other Primary Care facilities, the Executive has been asked to reply directly to the Deputy.

Hospital Funding

Questions (703)

David Cullinane

Question:

703. Deputy David Cullinane asked the Minister for Health the agency spend in acute hospitals for each quarter in each of the years 2018, 2019 and to date in 2020, by hospital and hospital group; and if he will make a statement on the matter. [16978/20]

Written answers

Minister for Health

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

Home Care Packages

Questions (704)

David Cullinane

Question:

704. Deputy David Cullinane asked the Minister for Health the current homecare waiting times; and if he will make a statement on the matter. [16979/20]

Written answers

Minister of State at the Department of Health

As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

Hospital Waiting Lists

Questions (705)

David Cullinane

Question:

705. Deputy David Cullinane asked the Minister for Health the current cataract wait time by county; and if he will make a statement on the matter. [16980/20]

Written answers

Minister for Health

The information requested by the Deputy is currently being collated by officials in my Department and will be provided to the Deputy directly as soon as it becomes available.

Hospital Waiting Lists

Questions (706)

Marian Harkin

Question:

706. Deputy Marian Harkin asked the Minister for Health when TILT tests will recommence at Sligo University Hospital; the number of persons on the waiting list at the hospital; the average waiting time for a person on the list to be called; and if he will make a statement on the matter. [16991/20]

Written answers

Minister for Health

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 Organization guidelines, and the National Action Plan.

The trajectory of the disease means there is now an opportunity for increasing the provision of non-covid care including more routine care. 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.

Where possible, hospitals are working to find innovative ways to enable service provision, which include virtual clinics for some outpatient department appointments. The HSE website provides details on services currently available and operational in each hospital on its website. This information is reviewed frequently and provides up-to-date announcements on services available at each site (https://www2.hse.ie/services/hospital-service-disruptions/hospital-service-disruptions-covid19.html).

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 24 June. 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.

As the system continues to deliver Covid-19 and non-Covid 19 care side-by-side over a more prolonged period, my Department and the HSE will continue to work closely together to protect essential non-Covid 19 acute care and progress the provision of more routine non Covid-19 care.

In regard to the information requested by the Deputy concerning Tilt Table Tests at Sligo University Hospital, as this is a service matter, I have asked the HSE to investigate the matter and provide you with a direct response.

Child and Adolescent Mental Health Services

Questions (707)

Gary Gannon

Question:

707. Deputy Gary Gannon asked the Minister for Health the staffing levels for CAMHS teams in CHO9; and the way in which this compares with the necessary full complement of staff as outlined by A Vision for Change. [17012/20]

Written answers

Minister of State at the Department of Health

As this is a service matter I have asked the Health Service Executive to respond to this directly as soon as possible.

Hospital Staff

Questions (708)

Gary Gannon

Question:

708. Deputy Gary Gannon asked the Minister for Health the number of additional theatre staff recruited in 2019 and to date in 2020 for each public and voluntary hospital for the purposes of increasing theatre capacity, in tabular form [17013/20]

Written answers

Minister for Health

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

Health Services

Questions (709)

Matt Carthy

Question:

709. Deputy Matt Carthy asked the Minister for Health if 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 is covered by the health service; and if he will make a statement on the matter. [17022/20]

Written answers

Minister of State at the Department of Health

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

Covid-19 Pandemic

Questions (710)

Matt Carthy

Question:

710. Deputy Matt Carthy asked the Minister for Health if there will be a revision to the Covid-19 restrictive guidelines as they pertain to agriculture marts; and if he will make a statement on the matter. [17024/20]

Written answers

Minister for Health

On 19 June 2020, the then Taoiseach, on behalf of the Government, announced the restrictions that would be eased and the measures that will be in place in Phase 3 of the Roadmap for Reopening Society & Business. On Thursday 25th June the Government confirmed the move to Phase 3 of the Roadmap from Monday, 29 June 2020. Information and advice about the restrictions that have been eased as part of Phase 3 and 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/.

The latest public health advice which applies to all circumstances is available on the websites of the HSE at https://www2.hse.ie/coronavirus/, the Health Protection Surveillance Centre at https://www.hpsc.ie/ and on the Government website at https://www.gov.ie/en/. This advice and guidance is updated on an ongoing basis.

I would also wish to draw the Deputy's attention to the Return to Work Safely Protocol, published by the Minister for Business, Enterprise and Innovation. This detailed guidance document was developed to assist employers and employees in the coming period and is available at https://dbei.gov.ie/en/Publications/Return-to-Work-Safely-Protocol.html. The Protocol is mandatory, and it applies to all workplaces right across the economy. Specific sectors may need to introduce additional safeguards, but this document sets out the standard set of measures required in every workplace.

Guidance in relation to specific sectors of the economy are matters in the first instance for the Government Department with responsibility for that sector. Matters relating to agricultural marts are the responsibility of the Department of Agriculture, Food and Rural Development.

Question No. 711 answered with Question No. 672.