Written Answers Nos. 371-390
371. Deputy Martin Browne asked the Minister for Health the supports his Department has made available for persons with dementia or Alzheimer’s since the start of March 2020; and the supports planned for the coming months. [27945/20]
View answerCovid-19 and the resultant lockdown have generated specific challenges for people with dementia. Day care and respite services have been suspended, and usual routines have been disrupted, creating additional pressures for people with dementia and their family carers.
My Department and the HSE have ensured that there has been a continued focus on meeting the needs of people living with dementia throughout the period of the Covid-19 pandemic. Through the Dementia Understand Together Campaign, led by the HSE and working with the Alzheimer Society of Ireland (ASI), a range of initiatives and resources have been developed, to ensure that people living with dementia stay safe, well and connected, during this time of crisis. The HSE is also signposting people with dementia to voluntary organisations for additional community supports.
The HSE has adapted its community services in order to provide a flexible response so that the needs of people with dementia continue to be met during the Covid-19 crisis. Primary care team support is operating nationwide, with referrals being made to community supports, including the ASI’s dementia adviser service and the local authority community response forums. While home visits have been necessarily restricted, the HSE uses prioritisation and screening measures to identify clients needing home visits.
My Department and the HSE are undertaking work to determine the current level of service delivery in the community and to set out plans, including associated required capacity, to resume services, including day services, in line with the Roadmap for Reopening Society and Business. This process will take on board the learning of the current period, including the possibility of delivering services in a new way, and the requirement to adhere to public health guidance. As part of this process, the National Dementia Office is developing a new model of care for dementia.
The HSE’s Memory Technology Resource Rooms (MTRRs) now have a central line, where people can speak to an occupational therapist for advice on Assistive Technology and aids to support people at home. The majority of MTRRs are now providing an adapted service through telephone and video assessment and consultation.
In addition, the ASI continues to support people throughout the Covid-19 crisis: its live chat, national helpline, home care, dementia adviser service, and online family carer training all remain up and running. Alzheimer Cafés have moved on-line and ‘virtual cafés’ are now taking place. The ASI has launched a new nurse line initiative with backing from the HSE and the Department of Health. The free call-back service offers people with dementia and family carers the opportunity to book a 1:1 session with a Dementia Nurse or a Dementia Adviser during the Covid-19 public health emergency. This creates a space for people with dementia and / or their families to raise issues that may be arising for them during the cocooning phase of the Covid-19 Emergency. This is hoped to assist people and may help plug the gap where Geriatrician appointments have had to be postponed due to Covid-19.
Guidance for re-opening day centres, including those for people with dementia, has been issued to CHOs. CHOs have been requested to undertake local risk assessments of centres to determine if infection, prevention and control measures can be put in place, to determine if social distancing can be maintained and in addition in order to determine approach to transporting clients to and from centres.
Advice issued from NPHET is that the over-70s, as medically vulnerable people, should continue to cocoon and not be in congregated settings. This cannot be facilitated in day centres unless the number of clients attending services are reduced. The HSE is committed to reopening day services but needs to determine Covid-19 testing strategy for these clients; mindful of increasing Covid-19 community transmission and resolve issues related to physical environments at day centres and ensure a safe transport strategy to facilitate people’s attendance at day centres.
372. Deputy Paul Murphy asked the Minister for Health his plans regarding the full restoration and preparation for the winter of day services, respite services and residential services for persons with disabilities, including children and adults with either physical or intellectual disabilities, in view of the fact that these measures are missing from the HSE winter plan 2020-21; and if he will make a statement on the matter. [27952/20]
View answerI was pleased to announce with Minister Donnelly this week that €10 million is being made available to support the resumption of day services and enhanced home support services for disability service users. As issues around the resumption of disability day services are COVID specific, funding was sought from the National Action Plan on COVID-19.
Of this €10 million, €7.5 million will increase disability day services by one day a week for over 14,000 adults. €2.5 million will provide 210 intensive support packages to enable children and young adults to remain at home and in their communities.
The additional funding will further support the resumption of day services, which began to gradually resume throughout August and September. However, it should be noted that capacity in day service locations will be reduced, in line with public health guidance. 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.
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 reopened around the country is available. This information can be accessed at www.hse.ie/newdirections
With regard to respite services, the HSE’s A Safe Return to Health Services outlines a three phased approach to the return of health and social care services. In accordance with this plan, short-stay residential and emergency/residential respite re-opened from July to August with activity set to increase 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.
Residential settings are people’s homes as well as places where health and social care are provided, and so services and supports for those in long term residential settings continue. Where some regular activities for people with disabilities in long term residential care, such as attending separate day services, are curtailed, alternative supports are provided in the residential setting.
The Department of Health is very much aware of how difficult restrictions on visiting are for residents and their families, and it is hoped that re-introduction of restrictions can be minimised. As Dublin city and county has been placed on Level 3 of the Framework for Restrictive Measures, it is unfortunately the case that visits to long term residential care facilities are paused until Friday 9th of October, but service providers are asked to take account of exceptional circumstances and facilitate visits on critical or compassionate grounds where needed. All guidance is available on the HSPC website and reviewed regularly.
373. Deputy Claire Kerrane asked the Minister for Health if he is satisfied with the practice of general practitioners charging medical card holders for blood tests, routine and otherwise, with some charges as high as €40; if the HSE will be requested to review the practice; and if he will make a statement on the matter. [27968/20]
View answerPersons who are eligible for GP care without charge under the Health Act 1970 are not subject to any co-payments or other charges in respect of such services. There is no provision under the GMS GP contract for persons who hold a medical card or GP visit card to be charged for routine phlebotomy services provided by their GP which are required to either assist in the diagnosis of illness or the treatment of a condition and the HSE has advised GPs accordingly.
I am aware that, nonetheless, some GPs are charging GMS patients for phlebotomy services in some circumstances. The GP chronic disease management programme which is being phased in from this year will involve the ongoing monitoring of patients’ condition and any blood tests required in this context will be covered by the fees payable for this care.
However, it remains a matter of concern to me that a GMS and GP visit card patient might be charged for blood tests which are clinically necessary and I have asked my officials to discuss with the HSE what further solutions to this issue may be possible. If a patient who holds a medical card or GP visit card believes he or she has been incorrectly charged for routine phlebotomy services by his or her GP, then that patient should report the matter to their HSE Local Health Office.
374. Deputy Claire Kerrane asked the Minister for Health the cost of carrying out a blood test including all associated costs per test. [27969/20]
View answerUnder the GMS scheme patients who hold a medical card or GP visit card are eligible to have blood tests taken by their GP without charge. Patients who attend a GP on a private basis may be charged a fee by the GP for a blood test, and the rate may vary between GPs.
Regarding the actual cost of carrying out blood tests, as there are a number of different types of blood tests it is not possible to answer this question without knowing the type of tests being referred to. Officials in my Department were unable to clarify the nature of the blood tests concerned with the Deputy; on receipt of this information I will be happy for my Department to provide a further answer to this question.
375. Deputy Claire Kerrane asked the Minister for Health the process in which medical card holders charged for blood tests by their general practitioner can apply to the HSE for reimbursement; the length of time this process takes for persons; the number of applications received for reimbursement in 2017, 2018 and 2019; if he is satisfied with the current process; and if he will make a statement on the matter. [27970/20]
View answerPersons who are eligible for GP care without charge under the Health Act 1970 are not subject to any co-payments or other charges in respect of such services. There is no provision under the GMS GP contract for persons who hold a medical card or GP visit card to be charged for routine phlebotomy services provided by their GP which are required to either assist in the diagnosis of illness or the treatment of a condition and the HSE has advised GPs accordingly.
I am aware that, nonetheless, some GPs are charging GMS patients for phlebotomy services in some circumstances and I have asked my officials to discuss with the HSE what further solutions to this issue may be possible.
If a patient who holds a medical card or GP visit card believes he or she has been incorrectly charged for routine phlebotomy services by his or her GP, then that patient should report the matter to their HSE Local Health Office. The local management, upon being notified of potential inappropriate charging of GMS patients, carry out an investigation into each complaint and will, where appropriate, arrange for a refund of charges incorrectly applied by the GP.
Regarding the number of reimbursement applications and the length of time that process takes, as these are service related matters, I have asked the Health Service Executive to respond to the Deputy directly on these matters, as soon as possible.
376. Deputy Johnny Mythen asked the Minister for Health if a plan will be put forward to regulate the intracytoplasmic sperm medical sector taking into account the high cost and the high differential charges that couples face when going through the procedure. [27971/20]
View answerAs the Deputy is aware, currently there is no specific legislation in Ireland governing assisted human reproduction (AHR), although there is limited existing regulation relating to certain aspects of the AHR area.
Accordingly, the Government approved the drafting of a bill on AHR and associated areas of research, based on the published General Scheme of the Assisted Human Reproduction Bill. This comprehensive and far-reaching piece of legislation encompasses the regulation, for the first time in this country, of a wide range of practices, including advanced AHR treatments like in-vitro fertilisation (IVF) and intra-cytoplasmic sperm injection (ICSI).
The General Scheme also provides for the establishment of an independent regulatory authority for AHR, and a number of the main envisaged functions of this body relate to the licensing of AHR treatment providers and ensuring their compliance with the provisions of the legislation.
The drafting of the Assisted Human Reproduction Bill is ongoing by my officials, in conjunction with the Office of the Attorney General. It is not possible at this time to give definitive timelines for the completion of the draft Bill and its subsequent passage through the Houses of the Oireachtas. However, the enactment of the Bill is included in the Programme for Government.
Overall, the provisions outlined within the General Scheme will ensure that AHR practices and related areas of research are conducted in a more consistent and standardised way and with the necessary oversight.
The aim of the AHR legislation is to promote and ensure the health and safety of parents and others involved in the process while, most importantly, consideration of the welfare and best interests of children born as a result of AHR is the key principle underpinning the General Scheme.
377. Deputy Johnny Mythen asked the Minister for Health if he will consider increasing the drugs payment scheme for intracytoplasmic sperm treatment. [27972/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
378. Deputy Joan Collins asked the Minister for Health the number of primary school children who have tested positive for Covid-19 since school resumption up to 25 September 2020; and the number of secondary school students who have been tested positive in the same period. [27981/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
379. Deputy Joan Collins asked the Minister for Health the number of primary school teachers who have tested positive for Covid-19 since school resumption up to 25 September 2020; and the number of secondary school teachers who have tested positive in the same period. [27983/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
380. Deputy Joan Collins asked the Minister for Health the number of primary school children who have tested positive for Covid-19 since school resumption up to 25 September 2020; and the number of secondary school students who have tested positive in the same period. [27985/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
381. Deputy Joan Collins asked the Minister for Health the number of primary school teachers who have tested positive for Covid-19 since school resumption up to 25 September 2020; and the number of secondary school teachers who have tested positive in the same period. [27987/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
382. Deputy Kieran O'Donnell asked the Minister for Health if he will address the case of a person (details supplied); and if he will make a statement on the matter. [27994/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
383. Deputy Éamon Ó Cuív asked the Minister for Health his plans to ensure partners can attend appointments and births with women who are expecting babies to provide them with support at this very important time for couples; and if he will make a statement on the matter. [27995/20]
View answerI 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 any restrictions currently in place have been minimised as much as possible and will be subject to ongoing review.
I note that restrictions have eased somewhat in certain hospitals in recent weeks and I hope this will continue. However, the recent rise in the numbers of people infected with the virus, including healthcare workers, is very worrying and may impact on the pace of the easing of restrictions.
The Deputy may wish to note that the National Women & Infants Health Programme has developed a guidance document on restrictions in maternity hospitals/units and this issued to all maternity services last week. The paper seeks to ensure a consistent national approach to visitor restrictions, as far as is practicable and having due regard to local circumstances. Each maternity service/network has been requested to review visiting arrangements on a weekly basis, in the context of the issues and factors identified in the paper.
384. Deputy Jackie Cahill asked the Minister for Health the quantity of MSUD covered under the medical card for persons who have been diagnosed with maple syrup disorder (details supplied); and if he will make a statement on the matter. [28003/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
385. Deputy Robert Troy asked the Minister for Health if he will provide clarity on the availability of adequate supplies of flu vaccine for the coming months. [28008/20]
View answerThe HSE has placed orders for 1.35 million doses of the Quadrivalent Influenza Vaccine for the forthcoming winter. This vaccine will be made available to all persons in an at-risk group from 6 months up, other than children aged from 2 to 12 years old inclusive.
The HSE has also ordered 600,000 doses of the Live Attenuated Influenza Vaccine, which is delivered via nasal drops rather than by injection and will be made available to all children aged from 2 to 12 years old inclusive. Children outside this age group in an at-risk category will also be eligible for vaccination without charges.
The HSE is confident that the number of doses procured is sufficient to meet demand in the at-risk groups and this element of the vaccination programme has commenced. The vaccination programme for children is expected to commence from mid-October.
I understand that deliveries of the private supply of the intramuscular vaccine are expected to commence at the start of October. The Health Products Regulatory Authority Medicine Shortages Framework has not been notified of any shortages affecting the Irish market in relation to flu vaccines.
386. Deputy Louise O'Reilly asked the Minister for Health the amount spent by his Department and the HSE using a recruitment firm (details supplied) to hire additional staff for the health service since the onset of the Covid-19 crisis in March 2020. [28015/20]
View answerAs this is a service related matter, I have asked the Health Service Executive to respond directly to the Deputy, as soon as possible.
387. Deputy Jim O'Callaghan asked the Minister for Health the number of persons the HSE currently employs in a HR function; and the number on 1 January 2019 and 1 January 2020. [28016/20]
View answerAs this is a service related matter, I have asked the Health Service Executive to respond directly to the Deputy, as soon as possible.
388. Deputy Thomas Pringle asked the Minister for Health when an appointment will be arranged for a person (details supplied); and if he will make a statement on the matter. [28032/20]
View answerIt is recognised that waiting times for scheduled appointments and procedures have been impacted as a direct result of the COVID-19 pandemic.
In response to the Covid-19 pandemic the HSE had to take measures to defer most scheduled care activity in March, April, and May of this year. 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 the National Public Health Emergency Team (NPHET) in accordance with the advice of the World Health Organisation.
The resumption of services from June onwards has allowed for increased activity, with the HSE utilising innovative methods including telemedicine to facilitate patient appointments. Patient safety remains at the forefront of service resumption. To ensure services are re-introduced in a safe, clinically-aligned and prioritised way, hospitals are following HSE clinical guidelines and protocols which has resulted in reduced capacity and activity
The HSE continues to optimise productivity through alternative work practices such the use of alternative settings including private hospitals, community facilities and alternative outpatient settings.
The National Treatment Purchase Fund has also recommenced arranging treatment in both private and public hospitals for clinically suitable patients who have been waiting for long periods on public hospital waiting lists.
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.
389. Deputy David Cullinane asked the Minister for Health the reason dexcom G6 glucose monitoring systems are only available for those of certain ages through the HSE; and if he will make a statement on the matter. [28033/20]
View answerUnder the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for the administration of the community drug schemes; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.
390. Deputy Denis Naughten asked the Minister for Health when the dental clinic will resume at Roscommon University Hospital; and if he will make a statement on the matter. [28034/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
