Written Answers Nos. 724-743
724. Deputy Richard Bruton asked the Minister for Health the protocol for arranging a test for a person who does not have access to a car to drive himself or herself; if there is a backlog or delay in handling such tests; and if he is satisfied that there is a satisfactory clearing house for persons experiencing difficulties in this regard. [23706/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
725. Deputy Matt Shanahan asked the Minister for Health if he will address a matter (details supplied) regarding the cath lab at University Hospital Waterford; and if he will make a statement on the matter. [23707/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
726. Deputy Mark Ward asked the Minister for Health the procedure if a child on a waiting list for a psychology appointment turns 18 years of age before he or she receives treatment; if they join another list; and if he will make a statement on the matter. [23708/20]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
727. Deputy Richard Bruton asked the Minister for Health if the extension of general practitioner only cards to those up to eight years of age is going ahead in September 2020 as originally planned. [23710/20]
View answerThe Government is committed to increasing access to GP care without charges for children, an important healthcare measure that will remove a potentially prohibitive cost barrier to accessing GP care and will help to improve children’s health as they develop.
The Health (General Practitioner Service and Alteration of Criteria for Eligibility) Act 2020 was signed into law in August. This Act provides, amongst other things, for the phased expansion of GP care without fees to all children aged 12 years and under. The initial stage of this phased expansion will be the provision of GP care without fees to all children aged between 6 and 8.
The appropriate date for commencing the expansion remains under consideration in light of COVID-19 and the additional pressures the expansion might place on general practice in that context and in anticipation of the usual increase in demand for healthcare services over the winter period. This date will be determined in consultation with the IMO. It is important to ensure that any additional pressures placed on general practice will not limit its capacity to meet the needs of all patients in the community.
730. Deputy Cathal Crowe asked the Minister for Health if his Department will consider the pre-budget submission from an organisation (details supplied); and if he will make a statement on the matter. [23714/20]
View answerProtection of the vulnerable continues to be a Government priority, especially in these challenging times, and those with mental health issues are often among the most vulnerable in society.
Access to services is central to the Government’s commitments under Sláintecare and the new national mental health policy, Sharing the Vision, and the Programme for Government: Our Shared Future highlights these policies. The Government’s commitment to continued enhancement of mental health services is shown in ongoing increases in the mental health budget. Since 2012, €315 million has been added, bringing the mental health budget today to €1.026 billion, an increase of 44%.
Much has been achieved in mental health in recent years, but it is recognised that much remains to be done. Ireland is fortunate to have fundamentally robust legislation, policies and services that have been built up over time and which, overall, compare favourably internationally. More importantly, there are identified and widely agreed pathways to undertake further improvements in all these areas, including improved residential and community-based care for children and adults and psychiatry of later life.
Sharing the Vision promotes equitable access to quality, safe mental health care for all citizens. Service users and their families, carers and supporters will have timely access to evidence-informed mental health services. Tailored measures will be put in place to ensure that individuals with complex mental health difficulties can avail of services across the State without discrimination. This builds on the intent of A Vision for Change and Sláintecare and is expected to be implemented as part of a ten-year plan.
Sharing the Vision recognises and plans for the increasing need for mental health services and demand for more holistic person-centred responses. The ten-year plan addresses population needs through a focus on the requirements of individuals. It promises early intervention, with a focus on prevention and positive mental health promotion. This focus advocates a mental health system that works in partnership with service users and their families to deliver a range of integrated services and supports.
Establishment of the National Monitoring and Implementation Committee (NIMC), to oversee Sharing the Vision, is well advanced. The NIMC will drive reconfiguration, monitor progress against outcomes and deliver on commitments in the new policy.
This year has been exceptional. The Covid-19 pandemic has caused significant stress, anxiety, worry and fear for many people throughout the world, from the disease itself and from impacts such as increased social isolation, disruption to daily life and uncertainty about employment and financial security.
The HSE has continued to provide all community services, as far as possible, while following Covid-19 guidelines to ensure protection for patients and staff. Acute inpatient and community residential facilities have remained open and patients have been provided with services throughout the pandemic, although with reduced numbers in some settings.
Covid-19 has rapidly accelerated online delivery of mental health services. The Department of Health, with the HSE, has launched a number of initiatives to promote mental health and well-being, including the national Crisis Text-Line in June. An additional €2.2m has been provided for a mental health promotion and well-being campaign, through enhanced online supports, and to support the HSE psycho-social strategy. This will enable implementation of integrated tele-health solutions and improve existing online interventions. Examples are the free counselling sessions offered by HSE partners MyMind and online peer support groups for front line workers from Turn2me.
A key priority for Minister Butler and the Department is to update the 2001 Mental Health Act. The Act sets out the care and treatment of people (including children) with mental illness, including involuntary detention procedures and patient safeguards. The updating process is in line with expert advice, international best practice and human rights. The Department is finalising draft heads of a bill to amend the Act and hopes to finalise a draft bill by the end of 2020.
Another priority is the new forensic mental health facility at Portrane. This significant and modern facility is expected to open early next year. The new 170-bed hospital complex will replace the Central Mental Hospital Dundrum (103 beds) as a modernised National Forensic Mental Health Service. It will include a 120-bed central mental hospital, a 10-bed forensic child and adolescent unit and a 30-bed intensive care rehabilitation unit.
Funding will be sought in this year’s Estimates campaign to implement the short-term objectives of Sharing the Vision. This will, of course, be influenced by the availability of resources. However, the current budget of over €1 billion enables the HSE to maintain and develop its wide range of mental health and suicide prevention services. These span all specialties and ages, from mental health promotion and early intervention to acute inpatient care and clinical programmes such as self-harm and eating disorders. Improving access and reducing waiting lists, where possible, are key Government objectives, despite acknowledged recruitment difficulties and the greatly changed Covid-19 operational environment.
731. Deputy Catherine Murphy asked the Minister for Health the criteria that is used to determine if a minor and-or child requires a test for Covid-19; if his attention has been drawn to the case of a person (details supplied); and if he will make a statement on the matter. [23719/20]
View answerI would like to thank the deputy for bringing this to my attention, which my officials have passed on to the HSE.
In terms of assessment and testing pathways for children and minors, the Health Protection Surveillance Centre has in recent days issued clear instructions to all GP providers and published these on its website. For children aged from 3 months up to 13th birthday, the following summarises the criteria:
Testing is advised for any child with any of the following unless there is a strong clinical reason to do otherwise:
1. Fever (greater than or equal to 38.0°C; confirmed) in the absence of an alternative diagnosis (e.g. UTI, varicella) OR
2. A new cough, shortness of breath or deterioration in existing respiratory condition OR
3. Symptoms of anosmia (loss of sense of smell)*, ageusia (loss of sense of taste)* or dysgeusia (distortion of sense of taste)*OR
*If the child can express or describe these symptoms
4. Minor respiratory symptoms in a child who has other ill contacts, is part of an outbreak or is a contact of a proven case.
The HPSC documentation describes the assessment in much more detail. For those aged younger than 3 months, the usual assessment protocols apply. For those aged 13 years or older or who attend secondary school, the HPSC refers these to adult testing guidance.
732. Deputy Paul McAuliffe asked the Minister for Health the staffing numbers for the HSE pest control services in CHO 9; and if there are vacancies awaiting to be filled. [23721/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly as soon as possible.
733. Deputy Richard Boyd Barrett asked the Minister for Health the number of health workers in employment in terms of whole-time equivalents and by profession; the way in which this has increased in view of Covid-19 in terms of whole-time equivalents and by profession; his plans for permanently allocating the funding to increase capacity across the health service; the number and category of whole-time equivalents he will fund as a result; and if he will make a statement on the matter. [16791/20]
View answerFor the first part of the Deputy's question, the number of healthcare workers is publicly available here:
https://www.hse.ie/eng/staff/resources/our-workforce/workforce-reporting/national-reports.html
These reports are uploaded with the most up to date monthly information.
The Deputy's further questions have been referred to the HSE for response as soon as possible, as they are service related.
Please note, the HSE is currently examining the additional workforce capacity requirements in the context of COVID-19. The funding required for these posts will be considered in the context of the Budget and Estimates process for 2021.
734. Deputy Richard Boyd Barrett asked the Minister for Health if a thorough plan will be outlined for the reopening of day services for those with disabilities; and if he will make a statement on the matter. [22333/20]
View answerAs 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
735. Deputy Richard Boyd Barrett asked the Minister for Health his plans to increase public investment in public health and medical research in view of Covid-19; and if he will make a statement on the matter. [22647/20]
View answerMy Department plays a lead role in public health and medical research in Ireland. The Department supports research in these areas through the Health Research Board (HRB), a statutory body under the aegis of the Department and a lead agency in Ireland supporting and funding health research. With an annual budget of approximately €45 million, and management of an investment portfolio of approximately €200m, the HRB supports the conduct of clinical research and clinical trials, health services research, population health research, as well as managing a number of national health information systems on behalf of the Department. Furthermore, my Department provides funding for, and participates in, a multi annual Joint Research Programme in Healthcare Reform with the Economic and Social Research Institute, as well as the Irish Longitudinal Study on Ageing (TILDA).
In response to the COVID-19 pandemic, the HRB, as well as the aforementioned established research programmes, have incorporated COVID -19 related research into their work programmes and have already played an important role (among other agencies and the wider academic community) in providing research inputs to the various sub-groups of the National Public Health Emergency Team (NPHET). Therefore, increased research in this area is being funded through existing allocations. Increasing allocation of funding to account for the requirements for increased COVID - 19 research is currently being determined as part of the budget 2021 process.
I hope this clarifies the matter for the Deputy.
736. Deputy Violet-Anne Wynne asked the Minister for Health the status of phase one of the pilot scheme for personalised budgets; if the uptake for the pilot scheme has been properly advertised to ensure there is a sufficient mix of applications nationally; and if he will make a statement on the matter. [22431/20]
View answerIn light of COVID 19 and Government advice, the Personalised Budget Project was paused for new entrants on March 23rd. Existing participants continued to be supported by the Project Manager via telephone and email. Phase 1 recommenced on June 29th.
The HSE is looking for up to 180 adults with a disability to participate in this project over a two-year period. The project will run in two phases, with 90 adults taking part in each phase. Phase 1 commenced in October 2019 and Phase 2 will commence from September 2020.
A call for Expressions of Interest for Phase 2 opened on July 27th and closed on September 7th 2020 . There has been interest in this Pilot across all CHO (Community Healthcare Organisations) areas. The relevant team in the HSE is continuing to respond to all queries raised by individuals, families, advocates and service providers who have submitted an Expression of Interest in participating in the project.
Applications are welcomed from adults with a disability that are currently in receipt of HSE funded services; provided either directly by the HSE or through the non-statutory sector (including day services, residential services, respite services, rehabilitative training or personal assistance), and young people leaving school in 2020 that have a commitment to a funded day service.
737. Deputy Violet-Anne Wynne asked the Minister for Health the reason for the delay in supplying the required equipment to a person (details supplied); and if he will make a statement on the matter. [22430/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
738. Deputy Thomas Gould asked the Minister for Health his plans to reduce waiting times for an assessment of needs in County Cork. [22375/20]
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, as soon as possible.
739. Deputy Matt Carthy asked the Minister for Health if it is mandatory for HIQA inspections of nursing homes to include infection inspections; and if he will make a statement on the matter. [15756/20]
View answerSince 2009 the Health Information and Quality Authority, HIQA, has been 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 monitors compliance with nationally-mandated standards and regulations to ensure that older people are receiving safe, high-quality and person-centred care. HIQA takes a risk-based approach to inspection and when information is received to suggest that there is a risk to the wellbeing of residents, HIQA uses this information to decide which regulations will be inspected against. Registered providers are required to be compliant with regulation 27 of the Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2013 on infection control. HIQA also monitors compliance against the National Standards for infection prevention and control in community services, developed and put in place since 2018.
HIQA inspections can take place over one or two days, with the duration influenced by factors such as the:
- COVID-19 status of the centre
- reason for the inspection
- number of inspectors on inspection
- size of the centre
- findings during the course of the inspection.
Inspections progress rapidly in centres where residents are well cared for, the findings are good, and the provider is organised and the required documentation is readily available for review.
On foot of a National Public Health Emergency Team (NPHET) recommendation, on 23rd May, a COVID-19 Expert Panel on Nursing Homes was established to examine emerging best practice and recommendations to ensure that all protective COVID-19 public health and other measures to safeguard nursing home residents are planned and in place to respond to the ongoing impact of the COVID-19 pandemic over the next 6-18 months. On 19 August the COVID-19 Nursing Home Expert Panel’s report was published. The report contains 86 recommendations across 15 thematic areas including in relation to infection prevention and control.
Given the urgency associated with the ongoing protection of nursing home residents, the need to evolve preparedness plans and to be “winter ready”, a robust implementation framework is being established. An inter-agency Implementation Oversight Team to oversee the implementation of the recommendations of the report, to provide regular updates on the progress of implementation of recommendations, identify and mitigate any barriers to implementation and to report to the Minister for Health on an ongoing basis. The Oversight Team is chaired by the Department of Health and has met twice since its establishment. A Reference Group to facilitate ongoing early engagement and involvement in the implementation process with relevant national stakeholders is also being established. This Group will also meet later this month.
I am committed to ensuring that all measures required to prevent and manage an expected resurgence of COVID-19 continues to be a priority.
740. Deputy Matt Carthy asked the Minister for Health the number of protected disclosures made by HIQA employees in each of the years 2015 to 2019 and to date in 2020; the number of staff that made protected disclosures that are working on a full-time basis with HIQA; and if he will make a statement on the matter. [15757/20]
View answerNo protected disclosures were made to me by employees of HIQA during the period referred to by the Deputy.
However, protected disclosures may have been made by HIQA staff directly to HIQA management during this period.
742. Deputy Michael McNamara asked the Minister for Health when an application will be processed for a person (details supplied); and if he will make a statement on the matter. [23795/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
743. Deputy Éamon Ó Cuív asked the Minister for Health if guidelines in relation to visits to nursing homes will be amended to allow visits by families, subject to wearing personal protective equipment, particularly in cases in which there are patients that due to illness are speech and visually challenged, in view of the fact that isolation from family can cause deterioration in the patient and mental health issues; and if he will make a statement on the matter. [23800/20]
View answerPeople living in long-term residential care facilities are particularly vulnerable populations in the context of Covid-19 and have been identified by the World Health Organisation (WHO) to be at a higher risk of being susceptible to infection from this disease and for subsequent adverse outcomes. The actions and measures we have taken in Ireland to support nursing homes and their residents have evolved on foot of epidemiological data and guidance from the WHO and the European Centre for Disease Prevention and Control (ECDC). These measures have been both society wide as well as focused specifically on residential facilities.
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 advised that the gradual reintroduction of usual activities while taking public health precautions should commence. This is reflected in the latest advice on protecting the over 70s and the medically vulnerable and also in visiting guidance, both of which are issued by the Health Protection Surveillance Centre.
The HSPC has completed its most recent update of visiting guidance and it is available at https://www.hpsc.ie/az/respiratory/coronavirus/novelcoronavirus/guidance/infectionpreventionandcontrolguidance/residentialcarefacilities
This guidance is under constant review, balancing risks with benefit in line with the disease trajectory in the community.
