Tuesday, 15 Sep 2020

Written Answers Nos. 1-50

Cabinet Committees

Questions (13)

Richard Boyd Barrett

Question:

13. Deputy Richard Boyd Barrett asked the Taoiseach the Cabinet committees and working groups or units he has set up or is planning to set up in his Department. [22340/20]

Written answers

The Taoiseach

Following its formation, the Government established the following Cabinet Committees:

Cabinet Committee on COVID-19

·Cabinet Committee on Economic Recovery and Investment

·Cabinet Committee on Brexit and Northern Ireland

·Cabinet Committee on Environment and Climate Change

·Cabinet Committee on Housing

·Cabinet Committee on Health

·Cabinet Committee on Social Affairs and Equality

·Cabinet Committee on Education

·Cabinet Committee on Europe, and

·Cabinet Committee on Government Co-ordination.

Each of these Cabinet Committees will work to advance Government's priorities as set out in the Programme for Government particularly where cross-government collaboration is critical.

Cabinet Committees, where appropriate will be supported by a corresponding Senior Officials Group, generally chaired by an Assistant Secretary in my Department and with membership drawn from the relevant Government Departments. As in previous administrations, supporting Cabinet Committees is a core function of the relevant policy Division in my Department and is undertaken in addition to other responsibilities of the staff involved.

As set out in the Programme for Government, a new Shared Island Unit has been established within the Department of the Taoiseach to support a renewed push to use the potential of the Good Friday Agreement to deliver sustained progress for all communities.

This unit will work towards a consensus on a shared island and will examine the political, social, economic and cultural considerations underpinning a future in which all traditions are mutually respected. Staffing and further development of the work programme for the Unit is well underway and information on this will be provided over the coming weeks.

A Social Dialogue Unit has also been established as part of the Economic Division in the Department of the Taoiseach. This will look to build on existing work and structures already in place to support social dialogue such as the Labour Employer Economic Forum.

A number of cross-departmental groups already in place, will continue to operate - for example those dealing with COVID-19, Brexit Preparedness and Climate Change.

Questions Nos. 14 to 16, inclusive, resubmitted.

Cabinet Committees

Questions (17)

Paul Murphy

Question:

17. Deputy Paul Murphy asked the Taoiseach when the Cabinet committee on Education will next meet. [22654/20]

Written answers

The Taoiseach

The Cabinet Committee on Education was established by Government decision on 6 July last. The first meeting will take place in the coming weeks.

It will oversee implementation of Programme for Government commitments in the area of Education.

In addition to the meetings of the full Cabinet and of Cabinet Committees, I meet with Ministers on an individual basis to focus on particular issues.

Question No. 18 answered orally.

Departmental Functions

Questions (19, 20)

Ruairí Ó Murchú

Question:

19. Deputy Ruairí Ó Murchú asked the Taoiseach if presidential voting rights will be included within the shared island unit of his Department; the timeframe for establishment of the unit; and the status of the process to date. [22374/20]

Matt Carthy

Question:

20. Deputy Matt Carthy asked the Taoiseach the status of the activities of the shared island unit in his Department. [22612/20]

Written answers

The Taoiseach

I propose to take Questions Nos. 19 and 20 together.

The Programme for Government sets out the Government’s commitment to working with all communities and traditions on the island to build consensus around a shared future.

This work will be underpinned by the Good Friday Agreement and by the absolute respect for the principle of consent.

I want to see a renewed push to use the potential of the Good Friday Agreement to deliver sustained progress for all communities on the island.

The Government committed to establishing a Shared Island unit in the Department of the Taoiseach, to work towards a consensus on a shared island. This unit has now been established.

As set out in the Programme for Government, the unit will examine the political, social, economic and cultural considerations underpinning a future in which all traditions are mutually respected.

Strengthening social, economic and political links on the island and the promotion of all-island approaches to the strategic challenges facing Ireland, North and South will be key objectives for the unit.

The unit is led by an Assistant Secretary, with two staff appointed and further assignments in train. The work programme for the unit is currently being further developed.

The unit will work collaboratively across Government and with research, civil society, sectoral, business and community organisations on the island, and seek broad-based engagement with political and civil society representatives.

Finally, in relation to Presidential voting rights, as set out in the Programme for Government, we are committed to holding a referendum on extending the franchise at presidential elections to Irish citizens living outside the State, including in Northern Ireland. This is being progressed by the Minister for Foreign Affairs and the Minister for Housing, Local Government and Heritage.

Questions Nos. 21 to 36, inclusive, answered orally.

Covid-19 Pandemic

Questions (37)

James Lawless

Question:

37. Deputy James Lawless asked the Minister for Health if a review or analysis has taken place of the recent lockdown in County Kildare; and if he will make a statement on the matter. [23430/20]

Written answers

Minister for Health

At the outset, I would like to acknowledge the very significant impact of the recent measures on individuals, communities and businesses in Kildare Laois and Offaly. I am fully aware that the improved situation in these counties has been due to the willingness of everyone to adhere to the public health guidance and the measures that were implemented. I would like to publicly thank all the people of Kildare, Laois and Offaly for their efforts over the past number of weeks in reducing the spread of Covid-19 across their counties. I would also like to acknowledge the work of my colleague Deputy Lawless during this time.

We now know, through the work of those in the affected counties, and what happened to the virus, that localised measures do work. As part of our deliberations on the development of the Roadmap for Resilience and Recovery which will be published later today, the learnings from the introduction of the measures in Kildare, Laois and Offaly were considered.

The decision to apply additional, enhanced public health measures to Kildare was based upon the available epidemiological evidence that was emerging at that stage.

As with many outbreak control measures, the full effect of the public health measures applied can take up to two incubation periods (28 days) of the virus to see full effect. It is worth recalling that we are still within this timeframe.

Nevertheless, I can assure the Deputy that the National Public Health Emergency Team (NPHET) and the Department have examined the currently available epidemiological information in order to learn about the effects of the measures within Kildare and the surrounding areas.

In August, the cases per 100,000 population in Kildare, Laois and Offaly increased quickly and sharply. In Kildare, the increase in this incidence rate was initially driven by workplace outbreak related cases. Seven days later, a second peak emerged, driven primarily by household outbreak cases in the first instance as well as further workplace outbreak cases and isolated cases. The volumes of cases seen in Kildare during these peaks were as high as those observed at the height of the national epidemic in April of this year.

Since this time, the incidence rates in Kildare have dropped considerably, although it does remain one of the highest in the country currently. The average number of cases identified each day has also decreased significantly.

As with the rest of the country, the epidemiological situation will continue to be monitored closely by the Department, the HSE, the HPSC and the NPHET.

Hospital Funding

Questions (38)

Brendan Griffin

Question:

38. Deputy Brendan Griffin asked the Minister for Health the measures he is proposing to address the lack of adequate resourcing of University Hospital Kerry within the South/Southwest hospital group; if his officials will examine the reason the hospital is resourced poorly relative to similar grade hospitals elsewhere in Ireland; if he will address the imbalance; and if he will make a statement on the matter. [23669/20]

Written answers

Minister for Health (Deputy Stephen Donnelly)

Firstly, I would like to acknowledge the work done by Deputy Griffin in advocating for the people of Kerry. University Hospital Kerry is an integral part of the South/South West Hospital Group and provides comprehensive medical and surgical services not only in Co. Kerry but also in West Limerick and North Cork.

The HSE has advised that the Group has been working closely with UHK management and staff to enhance staffing, services and facilities, particularly over the last two years. The UHK budget has increased by 32% to €98m since 2015, while staff numbers have risen by 38% during the same period.

Additional resources have been provided to support maternity services, additional Emergency Department nursing posts, and the opening of a new 4-Bedded Acute Stroke Unit to manage approximately 200 strokes per year. The refurbishment of the intensive care unit has facilitated greater efficiency within the hospital’s critical care service and has enhanced compliance with infection control standards. Since the outbreak of COVID- 19 the hospital has received funding to construct COVID pathways in the Emergency Department and 15 additional surge beds have been opened in the last 2 weeks.

Deputy Griffin has also demonstrated his commitment in this House to ensuring that the communities in Kerry are provided with the best primary care services possible be that in terms of seeking improvement to physical infrastructure or additional staffing. I look forward to working with him to address his concerns and would hope, for example, that Kerry may benefit from some of the €10 million in funding that I have recently approved for enhanced community services.

These developments outline the commitment to achieve equity across the South/South West Hospital Group and to ensure that UHK can meet the needs of the community it serves. Our health services are facing unprecedented challenges in the months ahead. However, these developments will help to ensure that the necessary resources are in place to deliver safe patient care in University Hospital Kerry.

Questions Nos. 39 and 40 answered orally.

Medical Cards

Questions (41)

Emer Higgins

Question:

41. Deputy Emer Higgins asked the Minister for Health the system for providing medical cards to persons on palliative care; if a means test applies; the length of time the application process takes; and if he will make a statement on the matter. [23277/20]

Written answers

Minister for Health

Under the Health Act 1970, eligibility for a medical card is based primarily on means and does not provide for automatic eligibility based on having a particular disease or illness.

That said, it is vitally important we do as much as possible to support people in palliative care, including where appropriate through the provision of a medical card. I wish therefore at the outset to thank the Deputy for raising such an important issue.

The HSE has a compassionate system in place for the provision of medical cards when it is informed that a patient is receiving end of life treatment – that is when patients unfortunately have a prognosis of less than 12 months.

Importantly, these applications do not require a financial means assessment nor are they ever reassessed. This approach is appropriate and undoubtedly is a great source of assurance to persons who are receiving palliative care and in need of support.

I am informed that generally, such medical cards are active on the system within 24 hours of the HSE National Medical Card Unit reviewing a medical report and completed application form from a healthcare professional.

Individuals may also qualify for a medical card through the means assessment process. The HSE may exercise discretion and grant a medical card where individuals exceed the income guidelines.

Separately, I also note that since 2015 medical cards are awarded without the need of a financial assessment to all children under 18 years of age with a diagnosis of cancer.

Questions Nos. 42 and 43 answered orally.

Covid-19 Pandemic

Questions (44)

Niamh Smyth

Question:

44. Deputy Niamh Smyth asked the Minister for Health when the restrictions on visits to maternity units will be lifted at Cavan General Hospital and Our Lady of Lourdes Hospital, Drogheda; and if he will make a statement on the matter. [23704/20]

Written answers

Minister for Health

I acknowledge that the current restrictions in maternity hospitals are presenting difficulties and this is hugely regrettable. However, it is necessary to reduce footfall in order to protect women, babies, staff and our maternity service as a whole.

Maternity hospitals have performed well during the pandemic and have continued to keep women, babies and staff safe. The fact that there have been no Covid maternal deaths in this country,and that we have a had a low incidence in pregnant women, suggests that the current approach is working.

However, we must remain vigilant as services resume and higher numbers of people attend hospitals. Maternity hospitals rely on very specialised personnel; should an outbreak of COVID-19 occur in a maternity hospital, the ability to provide safe, quality care would be severely impacted. It should be remembered that maternity hospitals care for fragile infants at the extremes of prematurity.

All maternity hospitals are challenged by the pandemic, but those challenges vary considerably. Decisions on any restrictions are therefore made, implemented and reviewed at hospital level.

Decisions to restrict visitors in our maternity hospitals have not been taken lightly. Management and staff are acutely aware of the very important support provided by partners at the time of birth. I have been assured that maternity hospitals wish to facilitate this support as far as possible. In that context, I can assure the Deputy that restrictions, currently in place in Cavan and Drogheda, have been minimised as much as possible and will be subject to ongoing review.

Question No. 45 answered orally.

Covid-19 Pandemic

Questions (46)

Brendan Smith

Question:

46. Deputy Brendan Smith asked the Minister for Health if there will be changes to the memorandum of understanding with Northern Ireland in respect of Covid-19; and if he will make a statement on the matter. [23690/20]

Written answers

Minister for Health

A Memorandum of Understanding was formally agreed by the Chief Medical Officers of the Department of Health and the Department of Health in Northern Ireland in April. The MOU was entered into in order to strengthen North/South co-operation on the public health response to the COVID-19 pandemic.

The MOU has formalised and underpinned the significant engagement between the Ministers, the Chief Medical Officers, and the Departments throughout this pandemic. The MOU is facilitating greater co-operation and consistency of approach wherever possible on areas such as public health messaging, programmes of behavioural change, evidence base/modelling and contact-tracing.

My predecessor, Deputy Harris, and I have been in ongoing contact with the Minister of Health in Northern Ireland throughout this pandemic in relation to how each health system is implementing various public health responses. In addition, there has been significant engagement between the CMOs and officials in both jurisdictions. Minister Swann and I have met on two occasions to date.

Calls continue to be held regularly, including at a technical level, to facilitate information-sharing on topics such as modelling, testing and contact-tracing approaches, tracing apps and travel measures.

The MOU continues to have the support of both Administrations. The recent Plenary meeting of the North South Ministerial Council noted the MoU and welcomed the close and productive cooperation that has taken place between Health Ministers, Chief Medical Officers and health administrations, North and South, to deliver an effective public health response.

Question No. 47 answered with Question No. 35.

Departmental Policy Functions

Questions (48)

Catherine Connolly

Question:

48. Deputy Catherine Connolly asked the Minister for Health when the independent monitoring body for Sharing the Vision will be established; the details of the membership of the body; and if he will make a statement on the matter. [23688/20]

Written answers

Minister of State at the Department of Health

The refreshed national mental health policy, Sharing the Vision – A National Mental Health Policy for Everyone, published in June 2020, recommends that a National Implementation and Monitoring Committee (NIMC) be established to oversee implementation of the policy. This committee will be mandated to drive reconfiguration, monitor progress against outcomes and deliver on the commitments made in this policy, which will have a 10-year duration.

The Department of Health, in consultation with the HSE, is currently developing the terms of reference and membership requirements for this committee. It is expected that the committee will work with partners to evaluate performance against key performance indicators, and will check overall progress so that the system will be in a position to respond effectively to support population mental health needs. Furthermore, it is anticipated that sub-committees will be established to progress specific actions contained in the policy. The NIMC committee will report to the Minister of State for Mental Health & Older People, and to the relevant Cabinet Committee.

It is envisaged that the NIMC committee and sub-committees will be representative of those stakeholders involved in ensuring effective delivery of the policy recommendations, including strong service user, service provider and voluntary sector representation.

All input received during the consultation on the policy, and any other stakeholder views, will be considered in establishing the committee. The committee’s proposed membership composition and terms of reference, when finalised, will be submitted to the Cabinet. I anticipate that that the committee will be established by October 2020.

Hospital Facilities

Questions (49)

David Stanton

Question:

49. Deputy David Stanton asked the Minister for Health his plans to develop a community nursing and residential care unit at Midleton Community Hospital, County Cork; and if he will make a statement on the matter. [23691/20]

Written answers

Minister for Health

In early 2016, a Capital Programme for Older Persons Residential Centres was developed and agreed with the Department of Health in response to the introduction of HIQA’s National Residential Care Standards for Older People.

Of the 129 public nursing homes 57 of these required to be refurbished/upgraded and extended, while 33 required to be replaced. The remaining 39 units already complied with HIQA standards or do not have any long stay beds. Funding of €535m was allocated to this programme from 2016 to 2021. €150m of this funding is for the provision of new replacement Community Nursing Units by means of a Private Public Partnership procurement process.

Midleton CNU is one of the seven CNU’s currently included in a single bundle of CNU’s to be developed by Public Private partnership (PPP). The HSE are currently evaluating tender submissions for the PPP Project with a view to identifying the preferred tenderer in Q1 2021.

Design Teams and Technical Advisors have been appointed and planning permission has been received for all sites. The procurement of the PPP provider has commenced with the Prior Indicative Notice published in the Official Journal of the European Commission (OJEC), the evaluation of the tenders is completed and the competitive dialogue is now underway.

It is important to recognise that the delivery of capital projects is a dynamic process and is subject to the successful completion of the various approval stages, in line with the Public Spending Code, which can impact on the timeline for delivery.

Hospital Facilities

Questions (50)

Cormac Devlin

Question:

50. Deputy Cormac Devlin asked the Minister for Health the details of future plans within the St. Vincent's Healthcare Group, in particular St Michael’s Hospital, Dún Laoghaire, and St. Columcille’s Hospital, Loughlinstown, County Dublin. [23660/20]

Written answers

Minister for Health

St Vincent’s Healthcare Group, comprising St Vincent’s University Hospital, St Michael’s Hospital and St Columcille’s Hospital, is part of the Ireland East Hospital Group.

Each hospital in the Group has a vital role to play, with smaller hospitals such as St Michael’s Hospital and St Columcille’s Hospital managing routine, urgent or planned care locally, and more complex care managed in the larger hospitals.

There has been a number of new developments at these hospitals recently; at St Columcille’s, funding has been received for the building of a purpose-built weight management centre, which is now at the design stage and last week, funding was approved for the National Gender Service at the hospital.

A Heart Failure Virtual Consultation Service for the benefit of patients of St Vincent’s and St Michael’s has been established, as well as an End to End Respiratory Model which will provide co-ordinated services for patients in the community, reducing demand on hospital services.

As part of the implementation of Sláintecare, there is a strong focus at national and Hospital Group level, working with CHOs, on the redesign of health services to promote greater integration, including the establishment of regional health areas. Plans for the hospitals will be taken forward in this context.