Written Answers Nos. 51-70
51. Deputy Paul Murphy asked the Minister for Health the steps he will take to ensure that persons who suffered narcolepsy after receiving the Pandemrix vaccine receive appropriate compensation without the need for expensive court cases. [23676/20]
View answerThe State Claims Agency (SCA) has a statutory remit to manage personal injury claims on behalf of Delegated State Authorities including the Health Service Executive. The management of cases taken by persons who allege they developed Narcolepsy and/or Cataplexy as a result of receiving the H1N1 vaccine, Pandemrix, is delegated to SCA and, as such, the Government has no role in determining how these cases are conducted. I understand that it is the Agency’s preference to resolve claims using mediation where possible.
Separately, an Expert Group was established by the Government in June 2018, chaired by Mr Justice Charles Meenan, to examine the law in relation to personal injuries arising in the healthcare context and to explore alternative mechanisms by which claims could be managed more effectively, particularly from the perspective of the person on whose behalf a claim has been made. A report from this Expert Group was received by the Minister for Health and the Minister for Justice earlier this year, and I am considering how best to act on this report - I intend to bring forward a number of reforms that are recommended.
52. Deputy Dara Calleary asked the Minister for Health when he expects health and social care services for persons with disabilities to be fully restored; and if he will make a statement on the matter. [23429/20]
View answerHealth and social care responses to the current public health emergency are under continuing review. The HSE have developed a number of working groups to plan and develop guidance on how we will be able to deliver supports, albeit in a new way and under the Public Health guidance. This includes groups on children’s services, adult day services and respite.
The vast majority of day services have now reopened with the remainder due to reopen over the coming weeks. When day services resume, capacity in day service locations will be reduced, however, the HSE and service providers will keep this measure under review and as public health guidance evolves, capacity to provide supports will adapt accordingly. Both the HSE and service providers are committed to maximising the support that can be provided within these restrictions.
At the end of July, the HSE issued the Guidance to Support Resumption of Children’s Disability’s Services to its individual Community Healthcare Organizations. The Guidance clearly maps the pathway to access of services and supports.
The HSE’s A Safe Return to Health Services outlines a three phased approach to the return of health and social care services. This plan states that short-stay residential and emergency/residential respite will begin to re-open from July to August with activity increasing in the next two phases September – November and December 2020 to February 2021. The main assumption underpinning this schedule is the level of illness and health service pressure caused by COVID-19. If this increases in later surges, the timelines in this document will change.
53. Deputy Martin Browne asked the Minister for Health if he will address a series of matters (details supplied) regarding additional supports to children and adults with disabilities and complex needs who have been impacted by the restrictions that have been in place since March 2020. [22356/20]
View answerAdult day services are a very important support service for the 19,000 people with a disability who attend them on a regular basis, and their families. As the Deputy will be aware disability day service locations closed in March.
The vast majority of services have now reopened with the remainder due to reopen over the coming weeks.
When day services resume, capacity in day service locations will be reduced, however, the HSE and service providers will keep this measure under review and as public health guidance evolves, capacity to provide supports will adapt accordingly. Both the HSE and service providers are committed to maximising the support that can be provided within these restrictions.
For the foreseeable future, remote supports and supports provided from service user homes will become a key feature of day service provision. The HSE and service providers will work to support families that are experiencing significant challenges.
Children’s Disability Services were stepped down in March 2020 in line with Government recommendations to minimise the spread of COVD-19. Through the pandemic, services continued to be provided in the most practical ways possible, especially to those children with the highest prioritised needs.
At the end of July, the HSE issued the Guidance to Support Resumption of Children’s Disability’s Services to its individual Community Healthcare Organizations. The Guidance clearly maps the pathway to access of services and supports.
54. Deputy Denis Naughten asked the Minister for Health the status of the development of the central sterile services department, CSSD, at Roscommon hospital; and if he will make a statement on the matter. [23275/20]
View answerThe HSE has advised that a submission was made to the HSE National Capital and Property Steering Committee in relation to a proposed Central Sterile Services Department project at Roscommon University Hospital in November 2018. A design brief and supporting documentation in relation to the development of a new CSSD at the Hospital has been prepared. Further information is currently being collated in order to future-proof decontamination requirements for the whole Saolta Healthcare Group, and to support the maximisation of surgical services across all hospitals in the Saolta Group, including Roscommon University Hospital. This information will inform any decision in relation to the development of a CSSD at the hospital. I am advised by the HSE that this exercise is expected to be complete in Q4, 2020.
It is important to recognise that all capital development proposals must progress through a number of approval stages, in line with the Public Spending Code. This includes detailed appraisal, planning, design and procurement before a firm timeline or funding requirement can be established. The final decision to proceed with the construction of any project cannot be made until the tender process has been completed and the costings reviewed to ensure that the proposal delivers value for money, remains affordable, and that sufficient funding is available to fund the project to completion. The delivery of capital projects is a dynamic process and is subject to the successful completion of the various approval stages, which can impact on the timeline for delivery.
55. Deputy Pauline Tully asked the Minister for Health if the report commissioned by his predecessor into the midwifery-led unit in Cavan General Hospital has been completed; if the reason for the initial suggested amalgamation with consultancy-led maternity services at the hospital has been explained; and if he will make a statement on the matter. [23648/20]
View answerFollowing reports of planned changes to midwifery led maternity service provision at Cavan General Hospital, my Department requested a full report from the National Women & Infants Health Programme. I have been advised that the review is currently on-going within the RCSI Hospital Group and it is envisaged that the report will the finalised by the end of September.
In the meantime, the Midwifery Led Unit at Cavan General Hospital is operating as normal and bookings are being accepted from women wishing to avail of the service. Once the full report has been received, my Department will work with the National Women & Infants Health Programme to ensure that any additional supports which are required to secure the future of community midwifery services in Cavan, will be put in place. This will ensure that the choice of the Supported Care pathway remains available to women attending Cavan General Hospital for maternity services and that maternity services will continue to develop in line with the National Maternity Strategy.
56. Deputy Denis Naughten asked the Minister for Health the status of the 50-bed ward block development at Portiuncula hospital, Ballinasloe, County Galway; and if he will make a statement on the matter. [23276/20]
View answerPortiuncula Hospital Ballinasloe aims to deliver a patient-centred, quality-driven focused service and provides a wide range of diagnostic and support services. The 50 Bed Ward Block is an important project for the hospital.
The Health Service Executive is responsible for the delivery and management of healthcare infrastructure and has advised that a contractor was appointed for the enabling works contract and commenced work on the 11th August 2020. The 50 Bed Ward Block enabling works project is programmed for completion on the 25th May 2021. It is intended to advertise for contractors for the construction of the 50 Bed Ward Block in Q4 2020 with a view to commencing works on-site in mid-2021. The Radiology Flouroscopy room refurbishment and equipment replacement is running in tandem, it is programmed for completion February 2021.
All capital development proposals must progress through a number of approval stages, in line with the Public Spending Code, including detailed appraisal, planning, design and procurement before a firm timeline or funding requirement can be established.
The final decision to proceed with the construction of a project cannot be made until the tender process has been completed and the costings reviewed to ensure the proposal delivers value for money and remains affordable, and that sufficient funding is available to fund the project to completion, including equipping and commissioning costs.
The delivery of capital projects is a dynamic process and is subject to the successful completion of the various approval stages, which can impact on the timeline for delivery.
57. Deputy James O'Connor asked the Minister for Health the reason for removing spectators from the matches of an association (details supplied), notwithstanding the controlled measures to limit the spread of Covid-19 implemented at such matches in line with public health guidelines; and if he will make a statement on the matter. [23682/20]
View answerI would like to begin by saying that I fully appreciate the vital role played by the GAA in respect of the health and wellbeing of communities the length and breadth of the country. The GAA is at the very heart of our community and the decision taken by the Government on the 18 August that all sporting events take place behind closed doors, is not in any way a reflection on the quality of the GAA’s facilities or the protocols put in place by the GAA to ensure the safety of the players, officials and the general public.
The overall Government approach to managing the COVID-19 pandemic is guided by the advice of the National Public Health Emergency Team (NPHET). As society and the economy have begun to open up, there has been a gradual change in the epidemiological situation across the country, and the NPHET advised the Government that a cautious but measured approach be taken.
In this regard, the NPHET recommended that all sporting events can continue to take place but behind closed doors. It is also advised that participants should practice 2 metre physical distancing before and after events, during breaks in play, on the side-lines and team huddles should be avoided. All necessary measures to comply with child protection still apply.
I have been informed by the NPHET that their concerns are not just around the risk associated with attendance at the games themselves, but also the risk of the spread of infection associated with people travelling to and gathering in different ways both before and after events that must be considered.
I can assure the Deputy therefore that the issue is not about spectators at matches, and it is not about targeting these restrictions at any cohort or sporting organisation in particular. We have had cases in clusters linked to sporting activities, but of more concern is the number of contacts of cases that have had to be followed up as a result of socialisation around sporting activity, house parties, other social engagements and car sharing.
The Deputy is correct when he states that the risk of transmission of the virus is lower outdoors, but it still exists, and the purpose of these measures is to prevent indoor and outdoor congregation, particularly where people from different households are mixing in a way that would spread the virus between households.
It is of critical importance that a low level of community transmission be maintained in order to ensure the protection of the most vulnerable in our society and to protect the priorities of our essential societal services, such as education and health and social care services. By protecting these essential parts of our economy and society, we are also ensuring that sporting activity can continue for all.
58. Deputy Richard Bruton asked the Minister for Health if the key indicators relating to Covid-19 are tracked relative to comparable countries such as the UK, Denmark and Austria and the EU as a whole covering such matters as testing rate per hundred thousand, hospital admissions per hundred thousand, reproduction rate of the virus, indicators of levels of social contact and so on; if so, if the indicators will be published on a regular basis; and if he will make a statement on the matter. [23273/20]
View answerIreland is guided by the advice, guidance and protocols of the World Health Organization (WHO) and the European Centre for Disease Prevention and Control (ECDC). The expert guidance of the ECDC in particular is based upon consideration of the circumstances arising in the European Union and globally. The National Public Health Emergency Team (NPHET) reviews these international developments as part of its overall examination of the evolving epidemiology of the disease.
While Ireland has taken its cue from international organisations such as the WHO and the ECDC in how we look at metrics related to the pandemic, it must be said that whenever we make comparisons across countries, we must do this cautiously. Circumstances such as, for example, the socio-economic status of the population, population density, age profile, rates of underlying conditions, date of first reported cases, varying data collection methodologies and reporting arrangements, testing strategies etc are often not directly comparable or are very challenging to analyse in a manner that can be directly comparable. The path and timeline of each country’s epidemic is also different. The metrics and policy responses used to combat the disease within each country have been unique to each country’s own individual situation and context. Simply comparing numbers doesn’t give the whole story.
It is therefore difficult to make direct international comparisons as countries experience different stages/waves of the epidemic at different times. Overall, Ireland’s response to this pandemic has been guided by international advice and emerging evidence and best practice. Information related to the current COVID-19 situation in Ireland and internationally is monitored continuously.
We have been transparent and open in sharing the most current position daily via press releases, press conferences and a publicly accessible online dashboard. This pandemic has required a dynamic response and enormous efforts have been made to ensure that our national data collection has kept pace with this very rapidly changing situation. Sharing information with the public has also been carefully balanced with the need to maintain keeping patient confidentiality.
Ireland’s 14-day incidence is now 40 per 100,000, up from a low of 3 in early July. Similarly, across the EU, most other member states seem to be experiencing an increase in their number of cases in recent weeks. Overall, the incidence rate is 55 cases per 100,000 population. 16 MS have a higher incidence rate in the past 2 weeks than in the previous 2-week period, while 11 member states have incidence rates above those currently recorded in Ireland.
59. Deputy Imelda Munster asked the Minister for Health when educational day services for children and adults with special needs will reopen; his plans for the reopening of same; and if he will make a statement on the matter. [19289/20]
View answerAdult day services are a very important support service for the 19,000 people with a disability who attend them on a regular basis, and their families. As the Deputy will be aware disability day service locations closed in March.
The vast majority of services have now reopened with the remainder due to reopen over the coming weeks.
When day services resume, capacity in day service locations will be reduced, however, the HSE and service providers will keep this measure under review and as public health guidance evolves, capacity to provide supports will adapt accordingly. Both the HSE and service providers are committed to maximising the support that can be provided within these restrictions.
For the foreseeable future, remote supports and supports provided from service user homes will become a key feature of day service provision. The HSE and service providers will work to support families that are experiencing significant challenges.
Children’s Disability Services were stepped down in March 2020 in line with Government recommendations to minimise the spread of COVD-19. Through the pandemic, services continued to be provided in the most practical ways possible, especially to those children with the highest prioritised needs.
At the end of July, the HSE issued the Guidance to Support Resumption of Children’s Disability’s Services to its individual Community Healthcare Organizations. The Guidance clearly maps the pathway to access of services and supports.
In relation to educational settings for children, this would be a matter for the Department of Education and Skills.
60. Deputy Matt Carthy asked the Minister for Health his plans to review the services provided at local hospitals, such as Monaghan hospital, in view of the additional pressures other centres will inevitably face in the coming period. [23657/20]
View answerMonaghan Hospital is part of the Cavan & Monaghan Hospital in the RCSI Hospitals Group. Together they share an integrated managerial and clinical governance system, as well as integrated patient care pathways and support functions.
The Smaller Hospitals Framework identifies the activities that can be performed in Model 2 hospitals, like Monaghan Hospital. It provides for a stronger role for smaller hospitals, such as Monaghan Hospital, in delivering a higher volume of less complex care, often closer to a patient’s home. It also ensures that patients who require emergency or complex planned care are managed safely in a larger hospital environment.
The Cavan & Monaghan Hospital Emergency Department is located in Cavan, with facilities in Monaghan focused on elective care and the appropriate streaming of patients to the Minor Injuries Unit. These Minor Injury Units help to provide valuable services to local communities and alleviate the pressures on Emergency Departments; this will prove to be especially vital in the coming months.
Other services provided at Monaghan Hospital include day services, theatre, diagnostic services, ambulatory care and a wide range of out-patient services. It also has 20 rehabilitation in-patient beds and 11 step-down beds, providing an invaluable service to patients following discharge from acute hospital services.
The Covid-19 pandemic led to an unprecedented interruption to normal health services. The HSE continues to plan for the challenges of providing health services in the Covid-19 environment and the Cavan & Monaghan Hospital will continue to play a critical role in the implementation of these plans.
61. Deputy David Cullinane asked the Minister for Health his plans to introduce medical cards for cancer patients and terminally ill patients; and if he will make a statement on the matter. [23643/20]
View answerUnder the Health Act 1970, eligibility for a medical card is based primarily on means. The Act does not provide for automatic eligibility based on having a particular disease or illness. However, the HSE does have 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.
These applications do not require a means assessment nor are they reassessed.
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.
Furthermore, 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.
I recognise however that not all terminally ill patients may qualify for a medical card and this understandably causes upset and concern.
To that end, the HSE Clinical Advisory Group (CAG) was established in December 2019 to review this issue. I can confirm that the work of the CAG group has concluded and a Report was submitted last week to my Department and is currently under active consideration.
62. Deputy Richard Boyd Barrett asked the Minister for Health his plans to ensure consistent and regular testing of all healthcare staff in view of the fact that the instance of Covid-19 among health care workers here is higher than in any other country; and if he will make a statement on the matter. [23665/20]
View answerA comprehensive, reliable and responsive testing and tracing operation is central to our public health strategy for containing and slowing the spread of COVID-19 and the HSE has worked intensively over the last number of months to put this in place and I would again like to acknowledge the huge work undertaken in this regard across the HSE.
Ireland is pursuing a robust testing strategy under the guidance of NPHET. NPHET will continue to consider and review, based on public health risk assessments, how best to target testing to hunt the virus in populations where it’s most likely and where it will do most harm. As the Deputy is aware, a serial testing programme for all staff in nursing homes has been in place since the end of June, with all staff tested on a fortnightly basis. NPHET is also giving ongoing consideration to the development and implementation of appropriate surveillance strategies for healthcare workers in other settings.
It is important to note that while testing is an important component of our response to Covid-19, it is only one element of our response and it doesn't replace the range of protective measures that are necessary to prevent the transmission of this disease.
63. Deputy Johnny Mythen asked the Minister for Health his plans to deal with the waiting lists for speech and language therapy in County Wexford. [22357/20]
View answerThe 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.
64. Deputy Verona Murphy asked the Minister for Health the status of the treatment pathway devised for mesh implant survivors; and if he will make a statement on the matter. [23650/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
65. Deputy Martin Browne asked the Minister for Health his views on the reopening of district hospitals for older persons and palliative care that have been closed to allow staff to be redeployed elsewhere due to Covid-19; his views on whether some of the facilities will reopen; and if he will make a statement on the matter. [23661/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
66. Deputy Brendan Griffin asked the Minister for Health the measures he is taking to fast-track the recruitment process for medical professionals throughout the health service; his views on the slow recruitment process; and if he will make a statement on the matter. [23670/20]
View answerAs this is an operational matter across a range of medical grades, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
It is accepted and I would share the view that the duration of the process for filling consultant posts was too long and needed to be addressed. The HSE has been progressing implementation of the recommendations of the 2017 Keane report “Towards successful consultant recruitment, appointment and retention”. These recommendations cover all of the key steps in the process from approval of the post to supporting retention following appointment.
The HSE is also conscious of the need, as highlighted by the former President of the High Court, to ensure that consultant and NCHD posts are filled by properly qualified medical staff to ensure the safe provision of services and is focused on ensuring that the recruitment processes are sufficiently robust to do so.
67. Deputy Thomas Gould asked the Minister for Health the status of his intervention to prevent the closure of a nursing home (details supplied) in County Cork. [23672/20]
View answerThis is a matter for the Independent Board.
Cork Kerry Community Healthcare appreciates the important role which Mount Cara House plays in its community. Mount Cara House is run by an independent board of directors. Alongside some limited funding from HSE Social Inclusion, it is also funded by Cork City Council and by residents themselves.
The independent board recently informed the HSE that it planned to close the facility. Since then, the HSE has been in on-going contact with the board with the aim of protecting the best interests of residents. It is understood that the board is now exploring a range of options, and the HSE respects that position. The HSE is providing advice and support to the board as they work to meet their obligations to residents.
Sage Advocacy provides support and advocacy service for vulnerable adults and is working with the residents in Mount Cara.
I have been updated by the Chairman of the Board, whose main aim is to protect the best interests of the residents, and I understand the Board is now exploring a range of options.
68. Deputy David Cullinane asked the Minister for Health his plans to tackle waiting lists and deliver public dental and orthodontic care; his further plans to expand eligibility; and if he will make a statement on the matter. [23645/20]
View answerThe Public Dental Service of the HSE treats children up to 16, and persons of all ages with special needs, through its dental clinics. All HSE dental clinics prioritise emergency care for children up to 16, treatment for special needs patients and screening of children aged from 11 to 13 years, including referral for orthodontic services where necessary. Orthodontic treatment is provided to those who have the greatest level of need and have been assessed and referred for treatment before their 16th birthday. There are no plans to expand eligibility for such care.
As the provision of public dental and orthodontic care is a service matter, I have asked the Health Service Executive to respond to the Deputy directly on waiting lists and the delivery of care, as soon as possible.
69. Deputy Verona Murphy asked the Minister for Health the reason the HSE wig allowance varies in terms of the amount one receives based on where one lives in Ireland; and if he will make a statement on the matter. [23649/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
70. Deputy Alan Dillon asked the Minister for Health the way in which he plans to deal with the key recommendations and lessons contained within the publication of the Covid-19 Mayo University investigation report; the Department which will oversee implementing of solutions to the key findings; and the timeline for same [23724/20]
View answer761. Deputy Alan Dillon asked the Minister for Health the way in which he plans to deal with the key recommendations and lessons contained within the publication of the Covid-19 Mayo University investigation report; and the Department which will oversee implementing of solutions to the key findings; and the timeline for same. [23852/20]
View answerI propose to take Questions Nos. 70 and 761 together.
The previous Minister for Health requested a report from the CEO of the HSE, on the Covid-19 measures taken at Mayo University Hospital (MUH) from the outset of the pandemic.
My Department received the report on 19 June. The report set out details of the Covid-19 planning undertaken at MUH as part of the overall work of the Saolta Healthcare Group, the considerable challenges faced at the outset and the actions taken to address these challenges.
The report also recommended areas of further action that should be addressed in the context of Covid-19 at the hospital. The HSE advises that MUH is implementing the Covid-19 measures as set out in the report and all immediate term measures are now in place, including the full Covid-19 batch testing now being executed on site, with the longest turnaround time for a test result in the hospital now less than 24hrs. A refurbishment programme of some existing ward accommodation has commenced and will complete in October 2020, resulting in improved facilities for patients.
The HSE also advises that MUH is working through the Saolta Healthcare Group and with HSE Estates to progress with the capital development process to increase in-patient capacity on the hospital site. This includes completion of a feasibility study in relation to the development of a 50 bedded ward block. In the interim, a temporary modular unit is progressing and is due to be on site by early November. As part of the hospital’s Winter Plan, MUH will utilise existing capacity in the new 40 bed acute ward in the Sacred Heart Hospital.
The Covid-19 pandemic has put significant pressure on health facilities in Ireland and worldwide. These key actions put in place at MUH provide assurance that a concerted effort continues to be made to deal with the Covid-19 pandemic.
