Tuesday, 8 Sep 2020

Hospital Appointments Status

Questions (1346)

Niamh Smyth

Question:

1346. Deputy Niamh Smyth asked the Minister for Health the reason a person (details supplied) is waiting so long for an appointment; and if he will make a statement on the matter. [22270/20]

View answer

Written answers

Minister of State at the Department of Health

The Programme for Government, Our Shared Future, recognises the need to improve services for both children and adults with disabilities through better implementation and by working together across Government in a better way.

The Government commits to prioritising early diagnosis and access to services for children and ensuring that the most effective interventions are provided for each child, to guarantee the best outcomes.

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

Cancer Services

Questions (1347)

Colm Burke

Question:

1347. Deputy Colm Burke asked the Minister for Health the status of CervicalCheck; if smear tests completed by general practitioners are being processed and results returned within four weeks; and if he will make a statement on the matter. [22275/20]

View answer

Written answers

Minister for Health

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

Hospital Appointments Status

Questions (1348)

Denis Naughten

Question:

1348. Deputy Denis Naughten asked the Minister for Health when a person (details supplied) will be called for their procedure; the reason for the delay in same; and if he will make a statement on the matter. [22276/20]

View answer

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 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 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. Further detail regarding the phases of service resumption are contained in the HSE’s ‘A Safe Return to Health Services’ document, published on their website on 22 July.

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 Health Service Executive to respond to the Deputy directly, as soon as possible.

Abortion Services Provision

Questions (1349)

Carol Nolan

Question:

1349. Deputy Carol Nolan asked the Minister for Health further to Parliamentary Question No.793 of 7 July 2020, the number of first initial consultations for termination of pregnancy services that were provided by general practitioners, family planning clinics and women’s health clinics in 2019; and if he will make a statement on the matter. [22277/20]

View answer

Written answers

Minister for Health

Information on the number of first consultations under the Health (Regulation of Termination of Pregnancy) Act 2018 is not notified to my Department.

The publication of information on the procedures carried out under 2018 Act is restricted in order to limit the risk of identification in what is a private, confidential matter between patients and their doctors.

While it will not be possible to provide the breakdown of consultations by service provider, I have asked the HSE to provide the Deputy with information on the overall number of first consultations for termination of pregnancy services provided in 2019.

Abortion Services Provision

Questions (1350)

Carol Nolan

Question:

1350. Deputy Carol Nolan asked the Minister for Health further to Parliamentary Question No.793 of 7 July 2020, the number of termination of pregnancies provided by each general practitioner in a community setting, family planning clinics and women’s health clinics, respectively in 2019, in tabular form; and if he will make a statement on the matter. [22278/20]

View answer

Written answers

Minister for Health

The Health (Regulation of Termination of Pregnancy) Act 2018 requires the Minister for Health, not later than 30 June in each year, to prepare a report on the notifications of terminations of pregnancy received by him during the immediately preceding year. In preparing a report under section 20 (5) of the Act, the Minister must exclude from the report information that identifies, or that could reasonably lead to the identification of a medical practitioner or a woman.

The first Annual Report on the Health was published on 30 June 2020. The report covers the period from 1st January 2019 until 31st December 2019. The Annual Report shows that in total 6,666 medical procedures were carried out under the Act in 2019.This includes 6,542 in early pregnancy under the grounds set out in section 12 of the Act.

A more detailed breakdown of the data is not available as material published on information contained in notifications to me is restricted in order to limit the risk of identification in what is a private, confidential matter between patients and their doctors.

Question No. 1351 answered with Question No. 1100.

Question No. 1352 answered with Question No. 1094.

Disability Services Provision

Questions (1353)

Kieran O'Donnell

Question:

1353. Deputy Kieran O'Donnell asked the Minister for Health if funding is available to assist families in County Limerick (details supplied) that have adult children with special needs in day care facilities that have been informed they can only attend the day care centre every second week due to Covid-19 restrictions. [22293/20]

View answer

Written answers

Minister of State at the Department of Health

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 8th 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 began to gradually resume during the month of August and will continue to do so throughout early September. Service providers are 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 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, and the latest update, a video message from the Head of Strategy and Planning HSE Disability Services, is available at the above link.

An information portal that contains the dates on which the 966 disability day service locations will reopen around the country is now available. Service users and families can access this information on www.hse.ie/newdirections

It has been recognised that additional costs may arise for service providers in providing safe services. To date, Government has approved COVID 19 Pandemic Health service funding of €2bn. The aim of this funding is to support investment necessary to address COVID 19, to mitigate risk of the spread of COVID 19 and to facilitate the provision of health and social care services against the backdrop of COVID 19. The HSE is in the process of reviewing and validating business cases from disability services providers for additional funding to support the reopening of services.

As the Deputy's question also pertains to a service matter, I have asked the Health Service Executive to reply to the Deputy directly, as soon as possible.

Fuel Poverty

Questions (1354)

Brendan Smith

Question:

1354. Deputy Brendan Smith asked the Minister for Health his views in relation to the health impact arising from fuel poverty here; his further views on the need for greater investment to prevent fuel poverty and the corresponding health consequences for persons; and if he will make a statement on the matter. [22308/20]

View answer

Written answers

Minister of State at the Department of Health

The Strategy to Combat Energy Poverty outlines that a household is considered energy poor if it spends more than 10% of their disposable income on energy costs. This can be caused by inadequate income, unsustainable energy costs and poor energy efficiency of housing.

Fuel poverty impacts on both physical and mental health across the life course. Studies show that exposure to cold resulting from fuel poverty can result in difficulties in weight gain and respiratory illness amongst children. There is also an increased risk of stroke, cardiovascular disease and respiratory illness amongst adults and, in particular, older persons. There is a direct link with fuel poverty and increased uptake of primary and acute health services and excess winter mortality amongst older cohorts following cold weather. The mental health impacts of fuel poverty are significant across all age cohorts.

The Department of Health together with the Department of Communications, Climate Action and Environment, the HSE and SEAI ran the Warmth and Wellbeing pilot scheme in CHO7 from 2016 until 2019. The scheme provided home energy retrofits for 1,350 homes with the aim of improving the living conditions of vulnerable children and older people, experiencing fuel poverty and living with chronic respiratory conditions. An independent research study into the impacts of the scheme on improved health and wellbeing and reduced health service use in partnership with the London School of Hygiene and Tropical Medicine is underway.

The Programme for Government has committed to investing €5bil over the next 10 years raised from the Carbon Tax to a National Retrofitting Programme. This programme will target the elderly and those at greater risk of respiratory illness and will thereby potentially reduce the incidence and consequent health impacts of fuel poverty on the most vulnerable. My Department will continue to work in partnership with officials from the Department of Communications, Climate Action and Environment to assist in the identification of medically vulnerable persons who will benefit most from this programme.

Covid-19 Pandemic

Questions (1355)

Cian O'Callaghan

Question:

1355. Deputy Cian O'Callaghan asked the Minister for Health the options available to answer questions on the Covid-19 health restrictions in place; if his attention has been drawn to the fact that the phone voice message of his Department indicates that the Minister’s office cannot be reached at this time (details supplied); the number or email to which clarifying questions should be directed for a timely reply; and if he will make a statement on the matter. [22352/20]

View answer

Written answers

Minister for Health

My office is contactable at Minister’s_Office@health.gov.ie and the query will then be directed to the appropriate officials to prepare a response. The volume of calls to my Office has increased at this time. Capacity to answer calls is also reduced as many people are continuing to work from home. Placing a query in writing is the most efficient way to get a response. Information is also provided in a number of channels, including media briefings. All information is updated daily on gov.ie.

Regarding the HSE Covid-19 hotline, as this is a service matter I have referred the Deputy’s query to the HSE for a direct response to him.

Covid-19 Tests

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 GMS and 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 a patient who holds a medical card or GP visit card 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.

HSE National Service Plan

Questions (1363)

Patricia Ryan

Question:

1363. Deputy Patricia Ryan asked the Minister for Health when the winter plan for the health service will be published; and if he will make a statement on the matter. [22404/20]

View answer

Written answers

Minister for Health

As a result of the significant impact of Covid-19 on routine health services, the health system is facing unprecedented challenges for the delivery of services. Resuming health and social care services and building health sector capacity and capability is a priority for the Government.

The HSE has developed a draft Plan which contains proposals for health service delivery for Winter 2020 to the end of 2021 and this is currently under review by my Department and the HSE.

The draft Plan has been formulated in the context of increasing demand for unscheduled care, the need to support continuity and resumption of elective services for non-Covid-19 healthcare, and the requirement to continue delivering essential healthcare in a Covid-19 context. The Plan comprises targeted initiatives to address population health needs which combine the need to shift care to home and ambulatory care environments, especially for high-risk cohorts such as elderly patients and those with chronic illnesses.

The Plan indicates the need for zero tolerance for overcrowding in care settings and acknowledges that this will require additional capacity in both acute and community care services. The various initiatives proposed in the Plan will aim to decrease acute hospital demand by enhancing community capacity, reduce unnecessary acute hospital admissions by enhancing alternative community care pathways, enable timely discharges from acute hospitals, and consequently reduce waiting times in hospital emergency departments.

The plan is currently under consideration in my Department and it is envisaged that it will be published shortly.

Covid-19 Tests

Questions (1364)

Patricia Ryan

Question:

1364. Deputy Patricia Ryan asked the Minister for Health if a less invasive Covid-19 test will be provided for children under 12 years of age; and if he will make a statement on the matter. [22405/20]

View answer

Written answers

Minister for Health

The accurate and timely detection of SARS-CoV-2 facilitates public health surveillance, response and control measures during the COVID-19 pandemic. The current standard of care in Ireland for the detection of SARS-CoV-2 (the virus that causes COVID-19) involves testing of clinician-collected combined nasopharyngealoropharyngeal specimens with reverse transcription polymerase chain reaction (RTPCR). RT-PCR is considered the 'gold standard' in diagnostics for the detection of SARS-CoV-2 ribonucleic acid (RNA) in the acute phase of infection.

The collection of nasopharyngeal swabs by healthcare workers involves an invasive technique that is uncomfortable for the patient, which is of particular concern for paediatric populations. A relative degree of skill is required by the provider, and due to risk of transmission, the procedure necessitates substantial personal protective equipment. Other issues include the potential for a shortage of swabs during large scale testing initiatives. Alternative specimens from the upper respiratory tract, such as saliva or nasal, may offer a means to mitigate these limitations.

In light of this, the Clinical Expert Advisory Group (EAG) which was established to support the National Public Health Emergency Team (NPHET) in their response to COVID-19 was requested to advise on the use of alternative clinical specimens or sites for the diagnosis of COVID-19, particularly for paediatric populations. An Evidence Review to inform this consideration was published by the Health Information and Quality Authority (HIQA) on 21st August 2020.

This issue continues to be under active consideration by the NPHET.

Midwifery Services

Questions (1365)

Patricia Ryan

Question:

1365. Deputy Patricia Ryan asked the Minister for Health the number of staff midwives working at the Midlands Regional Hospital Portlaoise; the number of staff midwives on long-term sick leave; the number of staff midwives that have left the hospital over the past two years; the number of staff midwives recruited in the hospital in the same time period; and if he will make a statement on the matter. [22410/20]

View answer

Written answers

Minister for Health

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