Written Answers Nos. 785-804
785. Deputy Fergus O'Dowd asked the Minister for Health the status of the proposed Dundalk primary care centre; if a site has been secured; if so, the full list of services that will be provided on site; the reason for the delays; and if he will make a statement on the matter. [23963/20]
View answerAs the HSE has responsibility for the provision, along with the maintenance and operation of Primary Care Centres and other Primary Care facilities, the Executive has been asked to reply directly to the Deputy.
786. Deputy Fergus O'Dowd asked the Minister for Health when the implementation of the €10 cap on hospital car park charges will be introduced to the Lourdes hospital car parks in Drogheda, County Louth (details supplied); and if he will make a statement on the matter. [23973/20]
View answerThe Programme for Government makes a commitment to introduce a cap on the maximum daily charge for patients and visitors at all public hospitals, where possible and to introduce flexible passes in all public hospitals for patients and their families.
This issue has been under active consideration in recent years. The HSE conducted a review of hospital car parking charges and submitted their report to the Department of Health in December 2018. My Department and the HSE are currently engaging on this issue in order to achieve this new Programme for Government commitment.
787. Deputy Neasa Hourigan asked the Minister for Health the percentage of Covid-19 tests in which the swab taken to lab result time exceeded 48, 72, 96 and 120 hours, respectively in July and August 2020, by community and hospital settings nationwide and specifically in the South/Southwest Hospital Group [23983/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
790. Deputy Bernard J. Durkan asked the Minister for Health the reason the HSE failed to input to the expert group on tobacco of the European Commission regarding breaches of the ban on menthol cigarettes when the issue was discussed by the group in June 2020; the reason menthol-flavoured tobacco products remain on shelves when the HSE has the power to remove them; the status of the investigation by the HSE into these breaches; and if he will make a statement on the matter. [23994/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
791. Deputy Jennifer Carroll MacNeill asked the Minister for Health the steps being taken to provide care for post-Covid-19 patients who may suffer ongoing fatigue or develop post-viral fatigue syndrome and if unable to get the correct advice and support may go on to develop myalgic encephalomyelitis; and if appropriate care is being provided for those at risk [23997/20]
View answer815. Deputy Marc MacSharry asked the Minister for Health further to Parliamentary Question No. 270 of 10 July 2019, the evidence Children’s Health Ireland relies on to adopt graded exercise therapy and cognitive behavioural therapy as treatments for children with myalgic encephalomyelitis; if HSE paediatricians follow the same treatment pathways, that is, supervised graded exercise programmes and cognitive behavioural therapy are commonly used to treat children with CFS; the risk of harm to children subjected to these treatments in view of findings (details supplied) and other associated research; and if he will make a statement on the matter. [24076/20]
View answer818. Deputy Marc MacSharry asked the Minister for Health the diagnostic criteria that will be used to differentiate between long-tail Covid-19, that is, those exhibiting a post-Covid-19 syndrome and those with myalgic encephalomyelitis in view of the fact that SARS and MERS outbreaks resulted in some persons having slow recovery and of those a sub-group went on to fulfil diagnostic criteria for ME; and if he will make a statement on the matter. [24079/20]
View answer819. Deputy Marc MacSharry asked the Minister for Health his views on the NICE statement July 2020 in relation to post-Covid-19 management and the associated guidance on pacing and conserving energy; his views on whether a statement regarding graded exercise therapy should be issued to healthcare professionals warning of the risks of the therapy and the appropriate management techniques for those living with myalgic encephalomyelitis with specific guidance to differentiate between those moderately and severely affected in view of the fact that the management techniques for those with myalgic encephalomyelitis include pacing and conserving energy (details supplied); and if he will make a statement on the matter. [24080/20]
View answer821. Deputy Marc MacSharry asked the Minister for Health the training healthcare providers currently make available to qualified staff in view of a recent EU ruling (details supplied); the training available to trainees in all healthcare disciplines; the steps being taken to identify the current lack of training; his plans to address the training needs; his plans to raise awareness among health professionals; his plans to raise the awareness of the public; and if he will make a statement on the matter. [24083/20]
View answerI propose to take Questions Nos. 791, 815, 818, 819 and 821 together.
Myalgic Encephalomyelitis (or encephalopathy) (ME) is a complex debilitating disorder which is characterised by severe fatigue accompanied by a range of other symptoms. ME is sometimes known as Chronic Fatigue Syndrome (CFS).
There is currently no known, specific, medical diagnostic test to determine or confirm a correct diagnosis of ME and no specific treatment which works for all sufferers is currently available. As a result clinical assessment and the design of care plans need to be tailored to the individual patient. There are assessments and tests which can be carried out in primary care settings by a General Practitioner. Specialised tests may be required when considering and ruling out other diagnoses. Relevant specialists are usually accessed through out patient clinics at secondary care level. The General Practitioner is regarded as best placed to refer patients, if appropriate.
Treatment for ME is tailored to address the varying symptoms presented by those affected by ME. In general, these treatments are delivered within the context of primary care, with referrals into secondary care for specialist interventions in the areas of Neurology, Rheumatology, Pain Specialists, Endocrinology, Immunology, Cardiology, etc. Different patients, depending on their primary symptoms, will require different Consultant input. The challenge in relation to ME is that it does not sit within one specialty, but crosses a number of specialties, with patients frequently attending different Consultants for management of their symptoms as and when they arise. Consultants are well used to coordinating the care of patients that require the input of their colleagues and other members of the multidisciplinary care team.
Work is under way as part of the implementation of the Strategy for the Design of Integrated Outpatient Services 2016-2020, specifically as regards addressing how and where the patient is treated and the classification of referrals with corresponding clinically recommended time-frames. Consideration is also being given to condition specific referral forms. This work should see significant improvements with respect to access to appropriate services.
The HSE provides a range of assisted living services including Personal Assistant and Home Support Services to support individuals to maximise their capacity to live full and independent lives.
PA and Home Support Services are provided either directly by the HSE or through a range of voluntary service providers. The majority of specialised disability provision (80%) is delivered through non-statutory sector service providers.
Services are accessed through an application process or through referrals from public health nurses or other community based staff. Individual’s needs are evaluated against the criteria for prioritisation for the particular services and then decisions are made in relation to the allocation of resources. Resource allocation is determined by the needs of the individual, compliance with prioritisation criteria, and the level of resources available. As with every service there is not a limitless resource available for the provision of home support services and while the resources available are substantial they are finite. In this context, services are discretionary and the number of hours granted is determined by other support services already provided to the person/family.
792. Deputy Pearse Doherty asked the Minister for Health the reason respite services have not resumed in a facility (details supplied) in County Donegal; and if he will make a statement on the matter. [24001/20]
View answerThe Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives.
As the Deputy's question relates to service matters, I have arranged for the question to be referred to the Health Service Executive (HSE) for direct reply to the Deputy.
793. Deputy Pearse Doherty asked the Minister for Health the financial supports available to islanders travelling to hospitals and overnight stays to access cancer treatment; and if he will make a statement on the matter. [24002/20]
View answerI have been advised by the National Cancer Control Programme (NCCP) that there are two services administered by the Irish Cancer Society which offer financial supports towards travelling for cancer treatment.
The first of these services is the Travel2Care Scheme - a limited transportation assistance fund, funded by the NCCP. This is available to patients travelling to a designated cancer centre, approved centres, or an approved children’s hospital and will cover part of the associated costs for said travel. Application for financial assistance from the fund requires that the patient meet the following criteria:
- Permanent residence in the state,
- Travelling over 50km to their designated cancer centre, approved centres, or approved children’s hospital,
- A genuine financial need for assistance,
- No qualification for other schemes, such as transport funded by the HSE or voluntary services such as the Volunteer Driver Service (however, it is possible for a child to receive assistance from both the Irish Cancer Society’s Children’s Fund and the Travel 2 Care scheme simultaneously).
Application is conducted using two separate forms depending on the treatment being travelled for. In the case of cancer tests, application can be made by submitting Form A to the Irish Cancer Society - which is available via cancer.ie, emailing travel@irishcancer.ie, calling 01 231 6643 / 01 231 0522 to request a copy, or by requesting a copy via the mail.
Form B is for ongoing treatment – such as surgery, chemotherapy, radiotherapy, or palliative care – and is only available from a healthcare professional such as a medical social worker or your G.P. Said healthcare professional is not obligated to provide the application form and must believe there is genuine need for financial assistance to provide it.
The following hospitals are covered by the Travel2Care scheme:
- Beaumont Hospital
- Mater Misericordiae University Hospital
- St James’s Hospital
- St Vincent’s University Hospital
- Cork University Hospital
- University Hospital Waterford
- Galway University Hospital
- University Hospital Limerick
- Letterkenny General Hospital (approved satellite centre)
- Our Lady’s Children’s Hospital Crumlin
- St Luke’s Hospital
- Whitfield Clinic (if you are a public patient travelling over 50kms for radiotherapy treatment)
- Altnagelvin Area Hospital
The second scheme available aiding those travelling for cancer treatment is the Volunteer Driver Service. This is a volunteer delivered transport service wherein patients are driven to and from treatment in designated partner hospitals and centres. Drivers are interviewed, trained, Garda vetted and must attend annual Support and Supervision sessions ran by the Irish Cancer Society to participate in the service.
The service is free to the patient, with all costs paid by the Irish Cancer Society, and applications are conducted by approaching a healthcare professional in a partnered hospital who will then discuss the suitability of it for the patients needs and make a decision on referral. Once referred, the patient must book appointments in advance with the Irish Cancer Society to arrange transport.
Participating hospitals and cancer centres for the scheme are:
- Cavan General Hospital
- Cork University Hospital
- The Mercy Hospital
- South Infirmary Victoria University Hospital
- Beaumont Hospital
- St. Vincent's University Hospital
- St. James' Hospital
- Mater Misericordiae University Hospital
- Tallaght University Hospital
- Connolly Hospital
- Letterkenny General Hospital
- Merlin Park University Hospital
- Galway University Hospital
- Portiuncula Hospital
- Kerry General Hospital
- Naas Hospital
- St. Luke's General Hospital
- University Hospital Limerick
- Our Lady of Lourdes Hospital
- Mayo General Hospital
- Midlands Regional Hospital
- Sligo General Hospital
- South Tipperary General Hospital
- University Hospital Waterford
- Wexford General Hospital
- Donegal Cancer Flights & Services, Ionad Naomh Pádraig, Upper Dore, Bunbeg, Letterkenny, Donegal
- The Community Intervention Team , Anam Cara, St Canice’s Road, Glasnevin, Dublin 11 (Outreach centre for The Mater and Beaumont Hospital)
794. Deputy Pearse Doherty asked the Minister for Health when a person (details supplied) will receive an orthopaedic appointment at Letterkenny University Hospital; if they are on the urgent or routine list; and if he will make a statement on the matter. [24003/20]
View answerIn response to the Covid-19 pandemic the HSE had to take measures to pause most elective scheduled care activity with effect from the end March 2020. This was to ensure patient safety and that all appropriate resources were made available for Covid-19 related activity and time-critical essential work. This decision was in line with the advice issued by National Public Health Emergency Team (NPHET) and in accordance with World Health Organisation guidelines, and the National Action Plan.
To ensure services are re-introduced in a safe, clinically aligned and prioritised way, the HSE launched its Strategic Framework for ‘Service Continuity in a Covid Environment’ on 24 June. Its implementation will ensure service resumption is done in an integrated way. This will involve a phased approach to ensure community services are strengthened. The Framework will also consolidate new ways of working and build on international knowledge. Further detail regarding the phases of service resumption are contained in the HSE’s ‘A Safe Return to Health Services’ document, published on their website on 22 July.
Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The National Waiting List Management Policy is a standardised approach used by the HSE to manage scheduled care treatment for in-patient, day case and planned procedures. It sets out the processes that hospitals are to implement to manage waiting lists and was developed in 2014 to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care.
In relation to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
795. Deputy Pearse Doherty asked the Minister for Health when a person (details supplied) will receive an outpatient gynaecology appointment; if the referral is routine or urgent; and if he will make a statement on the matter. [24004/20]
View answerIn response to the Covid-19 pandemic the HSE had to take measures to pause most elective scheduled care activity with effect from the end March 2020. This was to ensure patient safety and that all appropriate resources were made available for Covid-19 related activity and time-critical essential work. This decision was in line with the advice issued by National Public Health Emergency Team (NPHET) and in accordance with World Health Organisation guidelines, and the National Action Plan.
To ensure services are re-introduced in a safe, clinically aligned and prioritised way, the HSE launched its Strategic Framework for ‘Service Continuity in a Covid Environment’ on 24 June. Its implementation will ensure service resumption is done in an integrated way. This will involve a phased approach to ensure community services are strengthened. The Framework will also consolidate new ways of working and build on international knowledge. Further detail regarding the phases of service resumption are contained in the HSE’s ‘A Safe Return to Health Services’ document, published on their website on 22 July.
Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The National Waiting List Management Policy is a standardised approach used by the HSE to manage scheduled care treatment for in-patient, day case and planned procedures. It sets out the processes that hospitals are to implement to manage waiting lists and was developed in 2014 to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care.
In relation to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
796. Deputy Pearse Doherty asked the Minister for Health the number of patients waiting for hip replacement surgery at Letterkenny University Hospital, County Donegal in 2018, 2019 and to date in 2020, in tabular form. [24005/20]
View answerIn response to the COVID-19 pandemic the HSE had to take measures to pause most elective scheduled care activity with effect from the end March 2020. This was to ensure patient safety and that all appropriate resources were made available for COVID-19 related activity and time-critical essential work. This decision was in line with the advice issued by National Public Health Emergency Team (NPHET) and in accordance with World Health Organisation guidelines, and the National Action Plan.
The trajectory of the disease means there is now an opportunity for increasing the provision of non-covid care including more routine care, and many services resumed in May in line with NPHET recommendations.
To ensure services are re-introduced in a safe, clinically aligned and prioritised way, the HSE launched its Strategic Framework for ‘Service Continuity in a Covid Environment’ on 24 June. Its implementation will ensure service resumption is done in an integrated way. This will involve a phased approach to ensure community services are strengthened. The Framework will also consolidate new ways of working and build on international knowledge. Further detail regarding the phases of service resumption are contained in the HSE’s ‘A Safe Return to Health Services’ document, published on their website on 22 July.
In relation to the particular query raised regarding the number of patients waiting for hip replacement surgery at Letterkenny University Hospital in 2018, 2019 and to date in 2020, the National Treatment Purchase Fund (NTPF) has provided the information requested by the Deputy in the attached table.
Letterkenny University Hospital Waiting Lists for Hip Replacements 2018, 2019 and to end July 2020 by time band
|
Date |
0-3 mths |
3-6 mths |
6-9 mths |
9-12 mths |
12-15 mths |
15+ mths |
Small Volume Time Band |
|
20/12/2018 |
47 |
33 |
7 |
7 |
|||
|
20/12/2019 |
38 |
20 |
8 |
7 |
|||
|
30/07/2020 |
22 |
18 |
35 |
18 |
8 |
11 |
797. Deputy Mairéad Farrell asked the Minister for Health the way in which the paediatric cardiology network in University Hospital Galway has been developed to date in 2020. [24019/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly as soon as possible.
798. Deputy Pa Daly asked the Minister for Health the number of derogations from requirements to self-isolate for contacts of confirmed cases that have been granted or given within the HSE; and if he will make a statement on the matter. [24022/20]
View answerI have asked the HSE to respond to the Deputy directly on this operational matter.
799. Deputy Róisín Shortall asked the Minister for Health the direction given to staff in public hospitals in respect of face coverings and social distancing for staff and patients; and the system in place for ensuring compliance with the advice. [24027/20]
View answerThe HSE’s Health Protection Surveillance Centre has produced a range of guidance notes for COVID-19, including guidance for healthcare and non-healthcare settings. “Current recommendations for the use of Personal Protective Equipment (PPE) for Possible or Confirmed COVID-19 in a pandemic setting” contains guidance for healthcare workers on face coverings and physical distancing.
https://www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/guidance/infectionpreventionandcontrolguidance/ppe/Current%20recommendations%20for%20the%20use%20of%20Personal%20Protective%20Equipment.pdf
The HSE is responsible for issuing the guidance to all healthcare settings.
800. Deputy Róisín Shortall asked the Minister for Health his plans in respect of putting the wearing of face coverings on a statutory basis for staff and customers in retail settings; and if he will make a statement on the matter. [24028/20]
View answerThe public health advice relating to Covid-19, including that relating to face coverings, is kept under continuing review by the National Public Health Emergency Team (NPHET).
A person, without reasonable excuse, must now wear a face covering when using public transport, in retail outlets, shops and shopping centres, in other indoor spaces such as libraries, cinemas and cinema complexes, theatres, concert halls, bingo halls, museums, businesses carrying out cosmetic nail care or nail styling, hair care or hair styling, tattoo and piercing services, travel agents and tour operators, laundries and dry cleaners and licensed bookmakers.
The Regulations relevant to retail settings are the Health Act 1947 (Section 31A – Temporary Restrictions) (Covid-19) (Face Coverings in certain premises and businesses) Regulations 2020 (S.I No. 296/2020)
These Regulations do not apply:
- to a person under 13 years,
- to the occupier, manager or person in charge or a worker where there is a screen that separates them from other persons or the person takes all reasonable steps to maintain a distance of two metres
- to a member of the Garda Síochána in the course of performing his or her duties
These Regulations provide that it is a matter for the occupier, manager or person in charge to take all reasonable steps to engage with persons entering or in a relevant premises to inform them of the requirements to wear a face covering and to promote compliance with the requirement. It is therefore a matter for the management of the retail operator concerned to decide what he/she may accept in terms of a reason for not wearing a face covering.
The Deputy may wish to note that the requirement to wear a face covering in the situations described is a penal provision for the purposes of section 31A of the Health Act 1947 (No. 28 of 1947). Enforcement is a matter for An Garda Síochána.
A reasonable excuse includes when a person cannot put on, wear or remove a face covering because of a physical or mental illness, impairment or disability or without severe distress; to communicate with a person who has difficulties communicating; to provide emergency help or care to a vulnerable person; to avoid harm or injury or to take medication. In addition, in retail outlets, it is also permitted to remove the face covering to allow for identification when the sales of goods or services have a minimum age requirement, or to assist in the provision of healthcare or healthcare advice.
The current face covering advice is available at
- https://www2.hse.ie/conditions/coronavirus/face-masks-disposable-gloves.html
- http://www.gov.ie/facecoverings/
801. Deputy Róisín Shortall asked the Minister for Health the details of the new agreement with the private hospital sector in respect of the provision of capacity and services to cater for pressures arising from Covid-19; and if he will make a statement on the matter. [24029/20]
View answerA major part of the Government's Action Plan in response to Covid-19 was to substantially increase the capacity of public healthcare facilities to cope with the anticipated additional demand. In order to urgently ramp up capacity for acute care facilities, an arrangement was agreed with the private hospitals to use their facilities as part of the public system on a temporary basis, to provide essential services. A Heads of Terms of Agreement between the HSE and the Private Hospitals was agreed at the end of March 2020 and all 18 of the acute private hospitals signed up to it. Under the arrangement, all patients in the private hospitals were treated as public patients and their treatment was prioritised based on clinical need.
The agreement was reviewed at the end of May and the Government decided that the existing arrangement should not be extended beyond the end of June. It mandated the HSE to negotiate a new arrangement with private hospitals which would provide the HSE with full access to private hospital capacity in the event of a surge of Covid-19 and separately with ongoing agreed access, to enable the HSE to meet essential and elective care needs.
The HSE is currently working to secure access to private hospital facilities to support capacity requirements. A procurement process is currently in train to secure access to additional acute services and diagnostic capacity from private providers which is required to address capacity needs over the next two years.
The HSE is also undertaking bilateral discussions with individual private hospitals to seek to agree new arrangements which would provide the HSE with access to private hospital capacity in the event of a surge of Covid-19 cases.
802. Deputy Róisín Shortall asked the Minister for Health if arrangements will be made for Covid-19 case numbers by electoral division on a weekly basis; if not, the reason; and if he will make a statement on the matter. [24030/20]
View answerSince the National Public Health Emergency Team (NPHET) met for the first time, a commitment was given to collect and publish as much relevant data as possible while ensuring individual patient confidentiality is maintained at all times. While the nature and scale of the Covid-19 pandemic has been unprecedented, the collection of timely and comprehensive data has been instrumental in developing the health service response to Covid-19 and to the advice provided by NPHET and the Department of Health to assist Government decision-making in the wider response to the disease in Ireland.
Comprehensive national statistics, information and data about Covid-19, including a timeline of confirmed cases by date, is published on a daily basis on the Department of Health website at https://www.gov.ie/en/organisation/department-of-health/ and on the Covid-19 Data Hub and Dashboards available at https://covid19ireland-geohive.hub.arcgis.com/. The published data are based on official figures provided by the Health Protection Surveillance Centre (HPSC) and the Health Service Executive (HSE).
All datasets, charts and maps are updated on an on-going basis and in line with newly published data. Data in relation to COVID-19 confirmed cases at electoral division level are updated on a regular basis. However, the Deputy should note that care is required to ensure patient confidentiality is preserved and that no potential identification of individual patients arises. As a result, the data relating to confirmed cases by electoral division is not updated on as frequent a basis as the other data on the Data Hub.
The Deputy may also wish to note that a range data on the epidemiology of Covid-19 in Ireland is also published in the daily report by the Health Protection Surveillance Centre (HPSC) available at https://www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/casesinireland/epidemiologyofcovid-19inireland
803. Deputy Matt Carthy asked the Minister for Health if he has spoken formally with the Director General of the WHO since 1 July 2020; and if he will make a statement on the matter. [24053/20]
View answerI have not met World Health Organization Director General Dr Tedros Adhanom Ghebreyesus. However, I ha meeting on Zoom on 17 July last with Dr. Michael Ryan, Executive Director, WHO Health Emergencies Programme.
804. Deputy Matt Carthy asked the Minister for Health the estimated cost in 2021 of recruiting 120 extra paramedics. [24054/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
