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Tuesday, 28 Jul 2020

Written Answers Nos. 1014-1033

Covid-19 Pandemic

Questions (1014)

Emer Higgins

Question:

1014. Deputy Emer Higgins asked the Minister for Health further to Parliamentary Question No. 738 of 21 July 2020, the details on the number of users who have chosen to register their location in these areas when signing up for the application, in view of the fact the application requests users to provide their location when they register and that the locations in the question are included in the drop-down list from which users select; and if he will make a statement on the matter. [18678/20]

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Written answers

At an aggregate level from data up to 21 July 2020, there were 5,123,982 check-ins and 4,861,208 or 95%, have a location reference. To maintain privacy, it is not currently possible to release these figures at a lower level for the localities listed by the Deputy, as lower level data will have to undergo statistical disclosure control (SDC) protocols by the CSO before release. The CSO have advised my Department that these SDC protocols are currently in the build phase. The CSO will be reporting symptom check-in data at county level in the first instance on Ireland's COVID-19 Data Hub, and this data will then be made openly available on a public facing dashboard.

Hospital Services

Questions (1015)

Niamh Smyth

Question:

1015. Deputy Niamh Smyth asked the Minister for Health if essential lifesaving treatments will be resumed for persons with critical diagnoses, in particular cancer; if it will be ensured that persons with cancer are given the necessary treatments within a public or private hospital setting; and if he will make a statement on the matter. [18682/20]

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Written answers

In line with the National Action Plan for Covid-19, delivery of essential urgent non-Covid care continued throughout the pandemic. Cancer care and urgent cancer diagnostics were identified in the Action Plan as a priority.

Symptomatic Breast Disease Clinics and Rapid Access Lung and Prostate Clinics continued, with urgent case prioritised in line with National Guidelines. Throughput in these diagnostic clinics was reduced due to the prioritisation of urgent patients, the need to introduce new infection prevention and control measures, and a reduced number of referrals to symptomatic clinics as less people presented to their GP with symptoms. These clinics are now returning towards normal levels of referrals, albeit with reduced capacity due to the need for physical distancing and other infection protection and control measures.

Urgent cancer treatment including surgical oncology, radiation oncology and medical oncology also continued following the consideration of the risk:benefit ratio of treatment of individual patients, the prioritisation of time-sensitive treatment and the review of the location of the delivery of these cancer services. Capacity for these services will be impacted by the need for physical distancing and other infection protection and control measures.

The HSE's National Cancer Control Programme (NCCP) are assessing the capacity needs of cancer services in the coming period as part of the overall capacity plan being prepared by the HSE.

Mortality Rates

Questions (1016)

Mairéad Farrell

Question:

1016. Deputy Mairéad Farrell asked the Minister for Health the number of deaths from alcohol, drug overdose and suicide in each of the years from 2008 to 2019, in tabular form. [18683/20]

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Written answers

The data requested are presented in the table.

Deaths from alcohol, drug overdose and suicide in each of the years 2008 to 2019

Year

All Overdose deaths

Alcohol Overdose deaths (as a Subset of overall Overdose deaths)

Suicide

2008

387

157

530

2009

371

143

579

2010

339

151

523

2011

377

142

577

2012

356

129

578

2013

401

143

546

2014

370

121

566

2015

370

113

483

2016

368

138

506

2017

376

125

383

2018

352

2019

421

Data recorded in this table reflects total overdose deaths in the first column and deaths where alcohol was one, or the only drug implicated in the death as a subset of the total figure in the second column. This is due to the fact that individual cases may have more than one substance implicated.

References

Alcohol and Drug overdose information comes from the Health Research Board – National Drug Related Death Index https://www.hrb.ie/fileadmin/2._Plugin_related_files/Publications/2019_Publication_files/2019_HIE/NDRDI/2008-2017/National_Drug-Related_Deaths_Index_2008_to_2017_data.pdf.

Information on Drug and alcohol related poisoning is only published up to 2017. Due to the current circumstances NDRDI staff were unable to access coronial files to complete data collection on 2018 deaths since early March. They aim to return to data collection in the Dublin Coroner’s office by the end of this month with the plan to have 2018 data published by the end of this year or early next year depending on data collection access.

Suicide information has come from the National Office for Suicide Preventions’ briefing on CSO Suicide figures, and from the CSO website https://www.cso.ie/en/statistics/birthsdeathsandmarriages/suicidestatistics/.

Mental Health Services

Questions (1017)

Sorca Clarke

Question:

1017. Deputy Sorca Clarke asked the Minister for Health the number of From Timid to Tiger programmes facilitated by the HSE in 2019 and to date in 2020; and his plans to extend the programme. [18693/20]

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Written answers

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

Mental Health Services

Questions (1018)

Martin Browne

Question:

1018. Deputy Martin Browne asked the Minister for Health the number of services in which persons diagnosed with co-morbid addiction and mental health issues as a dual diagnosis are treated in an integrated setting, by county. [18699/20]

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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.

Mental Health Services

Questions (1019)

Martin Browne

Question:

1019. Deputy Martin Browne asked the Minister for Health the progress made by the HSE national clinical programme for assessing and managing patients who have a co-morbid mental illness and substance misuse issues dual diagnosis; if a comprehensive model of care has been developed; and the way in which the model of care has been introduced to those that need it. [18700/20]

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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.

Mental Health Services

Questions (1020)

Martin Browne

Question:

1020. Deputy Martin Browne asked the Minister for Health if he will confirm that a meeting with mental health groups in County Tipperary will take place in August 2020, as previously committed to; and if contact has been made with those organisations since the Minister of State paid a visit to Clonmel earlier this month. [18701/20]

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Written answers

I am happy to inform the Deputy that I have agreed to meet a number of mental health groups in Tipperary in August. My office recently received a formal request in this regard, and is awaiting a response from the requester so that a date, location and other relevant details can be agreed.

Mental Health Services

Questions (1021)

Martin Browne

Question:

1021. Deputy Martin Browne asked the Minister for Health the data that supports claims that a unit (details supplied) would not be up to specification to feature as an acute psychiatric unit; if a cost analysis has been carried out to determine the amount it would cost to bring it up to standard for such use; and if not, if a cost analysis for this purpose could be undertaken. [18702/20]

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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.

Mental Health Services

Questions (1022)

Martin Browne

Question:

1022. Deputy Martin Browne asked the Minister for Health his views on working with non-governmental organisations to complement the provision of public mental health services; his views on funding organisations that currently deliver integrated services for persons with dual diagnosis; if he will meet with those providing these services on a voluntary basis in County Tipperary. [18703/20]

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Written answers

Sharing the Vision - A Mental Health Policy for Everyone, stipulates that individuals with co-existing mental health difficulties and addiction to either alcohol or drugs should not be prevented from accessing mental health services. Consequently, it will not be necessary to establish whether a mental health difficulty is ‘primary’ for an individual to access the support of a mental health team. A shared case management approach may be required for particularly complex patients.

On this basis, the policy recommends that a tiered model of integrated service provision for individuals with a dual diagnosis (e.g. substance misuse with mental illness) be developed to ensure that pathways to care are clear.

With regards to service provision by NGOs, the policy recognises that the voluntary and community sector organisations are key partners in the design and development of HSE mental health services at national and local level, as well as referral partners for primary mental healthcare. Their services extend to therapeutic and other recovery supports for individuals and families, carers and supporters and can, therefore, help to reduce the use of inappropriate referrals to specialist mental health services.

The policy recommends that where Voluntary and Community sector organisations are providing services aligned to the outcomes in this policy, operational governance and funding models should be secure and sustainable. In addition, the policy also contains recommendations to ensure more integrated linkages between HSE mental health services and the Voluntary and Community sector.

I have agreed to meet a number of mental health groups in Tipperary in August. The details of this are being finalised between my Office and relevant local representatives.

Maternity Services

Questions (1023)

Pa Daly

Question:

1023. Deputy Pa Daly asked the Minister for Health if his attention has been drawn to the fact that many mothers nationwide have to attend pre-natal appointments without their birth partner (details supplied); if the potential will be investigated for a consistent pre-natal and birth partner protocol in all hospitals to mirror those in place in the Rotunda Hospital; and if he will make a statement on the matter. [18718/20]

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Written answers

It is of course desirable that the impact of Covid-19 on the pregnancy and birthing experience of women and their families is kept to an absolute minimum. The National Women & Infants Health Programme has provided assurance that the midwifery and obstetrical community are acutely aware of the important support provided by partners or companions and that they wish to facilitate this as far as possible.

However, in the context of the current public health emergency, each of our 19 maternity units/hospitals are facing significant challenges. Such challenges may vary considerably between units and, indeed, over time as the situation evolves. In that context, and in line with clinical advice issued by the Institute of Obstetricians and Gynaecologists, an individual unit or hospital may, under certain circumstances, be forced to restrict access of partners to outpatients appointments, maternity wards and delivery theatres. It is important to remember that these restrictions are put in place to minimise the risk of spread of Covid-19 in the community and to protect hospital staff and patients as much as possible.

Decisions on any restrictions in maternity hospitals are made, implemented and reviewed at hospital level and, while very regrettable, are necessary to protect the safety of patients, the wellbeing of staff and the operability of our maternity services. However, I can assure the Deputy that, in the context of what is a rapidly evolving situation, all restrictions will be frequently reviewed and reversed as soon as possible.

With regards to the specific issues raised by the Deputy, I have asked the Health Service Executive to reply to you directly.

Medical Cards

Questions (1024)

Patricia Ryan

Question:

1024. Deputy Patricia Ryan asked the Minister for Health if he will introduce a scheme in which online doctors could accept medical cards; and if he will make a statement on the matter. [18730/20]

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Written answers

General practitioners are private practitioners, the majority of whom hold a GMS contract with the HSE to provide medical services without charge to medical and GP visit card holders. To support the administration of a comprehensive GP service to GMS patients based as standard on the provision of in-person consultations, the GMS contract provides for, amongst other things, administrative related practices, practice supports, and the provision of specific in-person medical treatments. Online doctor or video doctor services are limited to provision of virtual consultations which are provided to patients on a private basis.

The 2019 GP Agreement for contractual reform and service development provides for the implementation and increased utilisation of a range of eHealth measures to improve the efficiency of health and GP services. However, there are no plans at present to introduce a scheme which would allow online-only doctors to provide GP services to GMS patients without charge.

Nursing Home Accommodation

Questions (1025)

Patricia Ryan

Question:

1025. Deputy Patricia Ryan asked the Minister for Health if he will write to an organisation (details supplied) and request it to ensure nursing home operators are offering tailored solutions in relation to family visits, to find a balance between the mental and physical health of the residents; and if he will make a statement on the matter. [18731/20]

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Written answers

The impact of COVID-19 on society in general and especially those living in nursing homes 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.

In line with the level of disease in the community, the National Public Health Emergency Team 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, issued by the Health Protection Surveillance Centre. This guidance is under constant review, balancing risks with benefit in line with the disease trajectory in the community. The HSPC has completed its most recent update of visiting guidance. It is now available on the HPSC website and is due to take effect from 29th July.

Nursing Homes Ireland were consulted on the guidance.

Information and Communications Technology

Questions (1026)

Patricia Ryan

Question:

1026. Deputy Patricia Ryan asked the Minister for Health his plans to ensure information technology equipment running an operating system (details supplied) currently in use in the HSE is replaced and that staff can make full use of software and avail of full virus protection; and if he will make a statement on the matter. [18736/20]

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Written answers

As this question relates to a service matter, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.

Dental Services

Questions (1027)

Patricia Ryan

Question:

1027. Deputy Patricia Ryan asked the Minister for Health if he will engage with an association (details supplied) on the cost of personal protective equipment to prevent dentists withdrawing from the dental treatment service scheme; and if he will make a statement on the matter. [18747/20]

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Written answers

My Department, in conjunction with the HSE, is examining the issue of the provision of PPE across all parts of the health service, including dental health service contractors.

Officials in my Department are engaging with the Irish Dental Association on this and other matters on an ongoing basis.

Medical Aids and Appliances

Questions (1028)

Éamon Ó Cuív

Question:

1028. Deputy Éamon Ó Cuív asked the Minister for Health the reason a product (details supplied) that constantly monitors glucose levels for persons with type 1 diabetes is not available under the long-term illness scheme; and if he will make a statement on the matter. [18754/20]

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Written answers

Under the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for the administration of the community drug schemes; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.

General Practitioner Services

Questions (1029)

Johnny Guirke

Question:

1029. Deputy Johnny Guirke asked the Minister for Health if he will provide a roadmap for the reopening of general practitioner and health centre services, many of which are continuing to provide diagnostic and prescription services by phone or internet only; and if he will make a statement on the matter. [18781/20]

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Written answers

I wish to assure the Deputy that general practice is has continued to operate during the public health emergency and GPs are still seeing patients where necessary, albeit with infection-control measures in place.

However, the exceptional circumstances faced by medical practitioners during the COVID-19 pandemic has resulted in a change in how GP services are delivered. At this time, walk-in clinics are not generally being provided and patients are asked to phone their GP initially to discuss their medical problem. GPs are performing assessments over the phone to determine if a patient needs to attend the surgery. Many problems can be resolved over the phone or by video consultation, some can be helped by the electronic transfer of a prescription to the pharmacist while others may need referral to other services. Where clinically indicated, the GP will arrange an appointment to see the patient in the surgery. These measures are necessary to ensure the safety of patients, GPs, and practice staff.

A joint Department of Health-HSE Community Capacity Working Group was established to oversee the work required in order to facilitate service restoration in the Primary and Community Sector.

This group’s work is aligned with, and has informed the HSE’s development and publication of, the strategic framework for service delivery entitled “Service Continuity in a COVID Environment” which outlines the basis for a consistent approach to decision making regarding the resumption of full service delivery, and also sets out the parameters for the more detailed operational planning which is currently taking place across the primary and community sector at local level.

These local plans will address any actions necessary to allow for the safe resumption of services and will outline the costs of preparations for any resumption of services. They will also describe the level of service to be provided and the expected timelines for activity to resume. These local plans will be submitted centrally to provide a single overview of implementation plans and activity levels.

Alongside these planning exercises, an increasing amount of Primary and Community services that were paused or scaled back due to the Covid-19 pandemic are now resuming locally, with priority service areas such as the Child Development Programme, the Chronic Disease Management programme, and various Health and Well-Being initiatives being amongst those in the first phase of resumption. Primary Care Therapeutic services are currently expected to resume fully over the Autumn period. It is important to note that some variation in service resumption across the Community Healthcare Organisations may be expected, depending on local capacity and the nature of service provision.

Medical Cards

Questions (1030)

Gerald Nash

Question:

1030. Deputy Ged Nash asked the Minister for Health when the revised income threshold for medical card applicants aged over 70 will be enacted following the abandonment of previous legislation; and if he will make a statement on the matter. [18811/20]

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Written answers

The 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 passed through the Houses of the Oireachtas on the 23rd and 24th July and is being prepared for signature by the President.

Disability Services Provision

Questions (1031)

Matt Carthy

Question:

1031. Deputy Matt Carthy asked the Minister for Health the status of the group home for persons with disabilities constructed at Drummond Otra, Carrickmacross, County Monaghan; if he will intervene to instruct the HSE to make the centre operational as a matter of urgency in view of the delays to date; and if he will make a statement on the matter. [18847/20]

View answer

Written answers

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

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

Prescriptions Charges

Questions (1032)

Richard Boyd Barrett

Question:

1032. Deputy Richard Boyd Barrett asked the Minister for Health if the 50 cent reduction for medication and prescriptions charges has been delayed; if so, the reason; and if he will make a statement on the matter. [18855/20]

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Written answers

As part of Budget 2020, the previous Government agreed that GMS prescription charges would be reduced by €0.50c for all medical card holders. Accordingly, the charge would be reduced by €0.50c to €1 per item for persons aged over 70 years, and by €0.50c to €1.50 for persons under 70. The maximum monthly charge would also be reduced to €10 and €15 respectively. The full year cost of implementing these measures is estimated at €25 million; a cost of €15 million for the over 70 cohort and €10 million for the under 70 cohort.

I am consulting with my government colleagues on these proposals.

Covid-19 Pandemic

Questions (1033)

Richard Boyd Barrett

Question:

1033. Deputy Richard Boyd Barrett asked the Minister for Health the breakdown of new Covid-19 cases; the percentage of new cases with serious symptoms; the percentage of those new cases who have lost the sense of smell; the age breakdown and demographics for new cases in three-week intervals; and if he will make a statement on the matter. [18856/20]

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Written answers

Since the National Public Health Emergency Team (NPHET) met for the first time, a commitment was given to collect and publish as much relevant data as possible while ensuring individual patient confidentiality is maintained at all times. While the nature and scale of the Covid-19 pandemic has been unprecedented, the collection of timely and comprehensive data has underpinned the efforts of the public health response to Covid-19 and has been instrumental in developing the health service response to Covid-19 and to the advice provided by NPHET and the Department of Health to assist Government decision-making in the wider response to Covid-19 in Ireland.

Comprehensive national statistics, information and data about Covid-19, including a timeline of confirmed cases by date, is published on a daily basis on the Department of Health website at www.gov.ie/en/organisation/department-of-health/ and on the Covid-19 Data Hub and Dashboards available at https://covid19ireland-geohive.hub.arcgis.com/. Datasets, charts and maps are updated on an on-going basis and in line with newly published data. The published data are based on official figures provided by the Health Protection Surveillance Centre (HPSC) and the Health Service Executive (HSE).

A daily Epidemiology of COVID-19 in Ireland report is published by the Health Protection Surveillance Centre (HPSC) available at https://www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/casesinireland/epidemiologyofcovid-19inireland. This report provides comprehensive information relating to Covid-19 cases arising in Ireland. The HPSC also publishes reports on underlying conditions in confirmed cases of COVID-19 available at https://www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/surveillance/underlyingconditionsreports/ and reports relating to cases in healthcare workers available at https://www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/surveillance/covid-19casesinhealthcareworkers/.

I would also direct the Deputy to the CSO website for access to a range of data relating to Covid-19. This is available on the CSO Covid-19 Information Hub at www.cso.ie/en/releasesandpublications/ep/p-covid19/covid-19informationhub/health/. This includes a range of data reporting on demographic information including age breakdowns, locations and other relevant information of those affected by Covid-19. It is not possible to report on specific symptoms such as anosmia at the point in time of a Covid-19 test being performed, as testing is primarily a laboratory diagnostic process rather than indicative of the symptoms that prompted a GP or other relevant health practitioner to refer a patient for a test.

The Deputy may wish to note that the data published to date is made available in a timely and comprehensive manner to inform the Department and wider Government response but also to ensure the public are kept informed to the greatest extent possible. There is also ongoing collaboration between my Department, the HPSC, the HSE, the Office of the Government Chief Information Officer, the CSO, Ordnance Survey Ireland and many other institutions and agencies to improve the data collected and the availability of it on an ongoing basis. I would like to assure the Deputy of my Department's ongoing commitment to publish as much Covid-19 data on an ongoing basis as is practicable, relevant and appropriate.

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