Tuesday, 8 Sep 2020

Long-Term Illness Scheme

Questions (1030)

Pat Buckley

Question:

1030. Deputy Pat Buckley asked the Minister for Health his plans to extend the list of conditions on the long-term illness scheme (details supplied); and if he will make a statement on the matter. [21244/20]

View answer

Written answers

Minister for Health

The LTI Scheme was established under Section 59(3) of the Health Act 1970 (as amended). The conditions covered by the LTI are: acute leukaemia; mental handicap; cerebral palsy; mental illness (in a person under 16); cystic fibrosis; multiple sclerosis; diabetes insipidus; muscular dystrophies; diabetes mellitus; parkinsonism; epilepsy; phenylketonuria; haemophilia; spina bifida; hydrocephalus; and conditions arising from the use of Thalidomide.

Under the LTI Scheme, patients receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge.

There are no plans to extend the list of conditions covered by the Scheme at this time.

The LTI Scheme will be included as part of a review of the current eligibility framework, including the basis for existing hospital and medication charges, to be carried out under commitments given in the Sláintecare Implementation Strategy.

In the meantime, for people who are not eligible for the LTI scheme, there are other arrangements which protect them from excessive medicine costs.

As you are aware, under the Drug Payment Scheme, no individual or family pays more than €124 a month towards the cost of approved prescribed medicines. The scheme significantly reduces the cost burden for families and individuals with ongoing expenditure on medicines.

For people who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be eligible for a medical card. In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE. In certain circumstances the HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income guidelines, where he or she faces difficult financial circumstances, such as extra costs arising from illness.

The HSE afford applicants the opportunity to furnish supporting documentation to determine whether undue hardship exists and to fully take account of all relevant circumstances that may benefit them in assessment, including medical evidence of costs and certain expenses. In circumstances where an applicant is still over the income limit for a medical card, they are then assessed for a GP visit card, which entitles the applicant to GP visits without charge. Further information on the medical card scheme and the application process are available at www.hse.ie.

Patients may also be entitled to claim tax relief on the cost of medical expenses. This includes medicines prescribed by a doctor, dentist, or consultant. Relief is at the standard tax rate of 20%. Details on how to claim are at www.revenue.ie.

HSE Data

Questions (1031)

Pádraig O'Sullivan

Question:

1031. Deputy Pádraig O'Sullivan asked the Minister for Health the details of the HSE psychology staff resource allocation including basic grade and senior grade for each CAMHS and adult community mental health team across the north Lee, south Lee, north Cork and west Cork catchment areas; and if he will make a statement on the matter. [21246/20]

View answer

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.

Covid-19 Pandemic

Questions (1032)

Paul Murphy

Question:

1032. Deputy Paul Murphy asked the Minister for Health if he will promptly initiate a public inquiry into nursing homes in view of the evident failings in the system of care for older persons contained in the HIQA report entitled, The Impact of Covid-19 on Nursing Homes in Ireland, of 21 July 2020 and in particular the findings regarding the way in which Covid-19 got into some homes but not others. [21254/20]

View answer

Written answers

Minister of State at the Department of Health

Since 2009 the Health Information and Quality Authority, HIQA, is the statutory independent regulator in place for the nursing home sector, whether a HSE managed or a private nursing home. The Authority, established under the Health Act 2007, has significant and wide-ranging powers up to and including withdrawing the registration of a nursing home facility, which means that it can no longer operate as a service provider. This responsibility is underpinned by a comprehensive quality framework comprising of Registration Regulations, Care and Welfare Regulations and National Quality Standards.

HIQA, in discharging its duties determines, through examination of all information available to it, including site inspections, whether a nursing homes meets the regulations in order to achieve and maintain its registration status. Should a nursing home be deemed to be non-compliant with the Regulations and the National Quality Standards, it may either fail to achieve or lose its registration status. In addition, the Chief Inspector has wide discretion in deciding whether to impose conditions of Registration on nursing homes.

During the response to COVID-19, Nursing homes continue to be regulated by HIQA, who under the Health Act 2007 have the legal authority to examine the operation of any facility under their remit. As you may be aware, HIQA conducted an inspection of the nursing home in question. The main objectives of this inspection are to determine the standards of care and support being provided to residents and to assess the registered provider’s statutory compliance with the regulations, as well as the governance, management and risk systems in place. The inspection report will be published in due course on the HIQA website.

The Deputy will be aware that the Nursing Homes Expert Panel Report was published on 19 August. The report includes 86 recommendations in total, over 15 thematic areas, with associated timelines for implementation over the short, medium and long term. An oversight structure has been established to ensure the implementation of the important recommendations contained in this Report. This encompasses the establishment of both an Implementation Oversight Team and a Reference Group.

The Implementation Oversight Team will determine an approach to, and oversee the implementation of, the relevant COVID-19 Nursing Homes Expert Panel recommendations.

Covid-19 Pandemic

Questions (1033)

Paul Murphy

Question:

1033. Deputy Paul Murphy asked the Minister for Health if he will report on the deaths to date due to Covid-19 in the HSE Crooksling and Tymon North nursing homes; the reason residents were moved from one facility to the other; if he will provide the communications with the families of residents; and if he will report on the relevant staffing issues. [21255/20]

View answer

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 the deputy directly, as soon as possible.

Hospital Services

Questions (1034)

Jackie Cahill

Question:

1034. Deputy Jackie Cahill asked the Minister for Health when outpatient physiotherapy and podiatry services will resume at the Community Hospital of the Assumption, Thurles, County Tipperary, in view of the fact the services are vital for older persons; and if he will make a statement on the matter. [21262/20]

View answer

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 the deputy directly, as soon as possible.

Covid-19 Pandemic

Questions (1035)

James O'Connor

Question:

1035. Deputy James O'Connor asked the Minister for Health if he will report on the self-isolation procedure for residents of nursing homes after returning from hospital even if they have tested negative for Covid-19 (details supplied); and if he will make a statement on the matter. [21266/20]

View answer

Written answers

Minister of State at the Department of Health

Nursing home providers are ultimately responsible for admissions to their homes and to further assist nursing homes the Health Protection Surveillance Centre has developed substantial public health guidance. An extensive body of guidance and support tools are available on the HPSC website. Guidance on resident transfers is addressed in the “Interim Public Health, Infection Prevention & Control Guidelines on Admissions, Transfers to and Discharges from Residential Care facilities during the COVID-19 Cases Pandemic (Version v1 O 28/07/2020) and the Interim Public Health, Infection Prevention & Control Guidelines on the Prevention and Management of COVID-19 Cases and Outbreaks in Residential Care Facilities V6.0 28/07/2020."

The guidance sets out the measures that should be adopted in relation to admissions to residential facilities. It notes that over the course of the COVID-19 pandemic, there has been significant learning about the role of testing for COVID-19 and its role in determining levels of asymptomatic infection and tracking spread of infection, especially in congregated settings, such as Residential Care Facilities. All transfers or new admissions should have a risk assessment, to ensure sufficient resources are available within the RCF to support social distancing and patient placement. In general residents transferred or directly admitted to a RCF should be accommodated in a single room (or room with no other residents) for 14 days after arrival and monitored for new symptoms consistent with COVID-19 during that time.

The guidance, which is under constant review, is available on the Health Protection Surveillance Centre’s website.

Hospital Funding

Questions (1036)

Niamh Smyth

Question:

1036. Deputy Niamh Smyth asked the Minister for Health the capital investment allocated to hospitals with the RCSI Hospital Group Beaumont Hospital, Cavan General Hospital, Connolly Hospital, Louth County Hospital, Monaghan Hospital, Our Lady of Lourdes Hospital, Drogheda and the Rotunda Hospital in tabular for the past 20 years; the year these investments were allocated; the details of the works; and if he will make a statement on the matter. [21268/20]

View answer

Written answers

Minister for Health

As the Health Service Executive is responsible for the delivery of public healthcare infrastructure projects, I have asked the HSE to respond to the deputy directly in relation to this matter.

Cancer Services

Questions (1037)

Niamh Smyth

Question:

1037. Deputy Niamh Smyth asked the Minister for Health the status of the full resumption of BreastCheck and cervical smear tests for those in need; if his attention has been drawn to concerns regarding the cessation of the assessments; and if he will make a statement on the matter. [21271/20]

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 Data

Questions (1038)

Brian Leddin

Question:

1038. Deputy Brian Leddin asked the Minister for Health the position regarding waiting times and numbers attending adult outpatient clinics for type 1 and type 2 diabetes in University Hospital Galway. [21279/20]

View answer

Written answers

Minister for Health

There is currently no waiting list for the Type 1 Diabetes outpatient clinic in University Hospital Galway. There are 158 patients on the waiting list for the Type 2 Diabetes OPD clinic, the longest of which is waiting 23 months.

The following table details the number of attendances at the Diabetes clinic in UHG for 2019 and 2020. (the 2020 figures are inclusive of virtual and telephone clinics - no such clinics held in 2019).

2019 DATA-ATTENDENCES	Jan	Feb	Mar	April	May	June	July	Aug	Sept	Oct	Nov	Dec	Grand Total
NURSE LED DIABETES CLINIC	26	30	18	27	23	10	26	16	16	35	21	0	248

DIABETES TRANSITION PAEDS CLINIC	7			10				6			3		26

DIABETES CLINIC	7		23										30

2020 DATA -ATTENDENCES-(inclusive of virtual clinics)	Jan	Feb	Mar	Apr	May	June	July	Aug	Sept	Oct	Nov	Dec	Grand Total
NURSE LED DIABETES CLINIC	16	18	35	41	42	47	61	56	9				325

DIABETES TRANSITION PAEDS CLINIC	6			10			7						23

Cancer Services

Questions (1042, 1043, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053)

View answer

Written answers

Minister for Health

I propose to take Questions Nos. 1042 to 1053, inclusive, together.

Cancer diagnostic services (including Rapid Access Clinics) have continued throughout the Covid pandemic, with appropriate restrictions for physical distancing and infection prevention and control (IPC). At this point, attendance numbers at urgent Symptomatic Breast Disease Clinics have returned to pre-Covid levels. While attendances are down for Rapid Access Lung Clinics, Rapid Access Prostate Clinics and non-urgent Breast Disease Clinics, they are showing a steady recovery. Monthly attendance figures, and time to treatment are being used to measure performance and recovery in Rapid Access Clinics. Related to this, and in the context of a reticence among people to visit GPs in the earlier phase of Covid-19, GP e-referrals are being monitored to determine the number of people with suspected cancers coming forward, and, as indicated, such referrals have increased.

Maintaining urgent cancer surgeries has been a priority for the National Cancer Control Programme (NCCP) throughout the Covid period. Clinical Guidance documents were developed by the NCCP, in conjunction with the relevant Surgical Oncology Clinical Leads Group. In many hospitals, the focus was on moving time sensitive and complex surgeries to private hospitals that had the required facilities and support services. Activity levels in surgical oncology are monitored on an on-going basis using HIPE data.

Radiation Oncology services continue to treat all newly referred patients. Given the extent of the equipment involved, and the purpose-built facilities for radiation oncology, services have remained, largely, within public hospitals. The focus is on ensuring that the maximum number of patients can be treated within the KPI timescales for radiation oncology. However, the ongoing need for social distancing and other IPC measures will result in capacity being reduced somewhat from pre-Covid levels in the coming months.

The majority of patients presenting for medical oncology services continued to be treated during the Covid period. However, throughput was reduced, partly because of less patients being referred. The challenges of social distancing and IPC measures will continue to impact and minor capital works are being considered, where feasible, as part of the means of addressing this. Monitoring of activity levels in medical oncology continues using HIPE data The Together 4 Cancer Concern initiative which was commenced in the context of Covid-19 involves community & telephone pyscho-social support for cancer patients, survivors and their families and carers. This is being done as a collaboration involving the NCCP, the Irish Cancer Society, Cancer Care West and the network of community cancer support centres across the country. It includes general and specialist psychological support delivered mainly though telephone and online platforms, with further supports being made available where required.

The possibility of further resourcing of cancer services to address the impacts of Covid-19 are being considered in the contest of the Winter/Continuity of Services Initiative.