Written Answers Nos. 499-516
499. Deputy Alan Kelly asked the Minister for Health the steps he is taking to ensure that the recommendations of a review (details supplied) are implemented; the recommendations acted upon to date; the timeline for the completion of each of the actions contained in the recommendations; and if he will make a statement on the matter. [30018/20]
View answerThe Report of the Independent Review Group established to examine the role of voluntary organisations in publicly funded health and social services, published in February 2019, highlighted the important contribution that voluntary organisations have made and continue to make in the delivery of health and social care services across the country.
The key finding in the Report is the need to strengthen the relationship between the State and the voluntary sector. To this end, a Dialogue Forum with Voluntary Organisations was established in December 2019 as recommended in the Report as a key mechanism for strengthening this relationship. The aim of the Forum is to build a stronger working relationship between the State and the voluntary healthcare sector for the benefit of patients and service users. The Forum will also facilitate regular dialogue with the voluntary sector on Sláintecare and other policy initiatives and will consider issues around governance more generally.
The Forum is independently chaired by Peter Cassells. Members of the Forum include the Department, the HSE, HIQA, the Mental Health Commission and the main representative bodies of voluntary providers of health and social care: The Wheel; Mental Health Reform; Disability Federation of Ireland; Not for Profit Association; National Federation of Voluntary Service Providers; Voluntary Healthcare Forum; Voluntary Hospices Group and National Community Care Network.
The Forum met twice in December and January, but further meetings scheduled for March 2020 and May 2020 were postponed due to the COVID-19 pandemic.
The Chair recently convened a sub-group of Forum to act as a planning group to assist him in planning and, where appropriate, progressing the work of the Forum over the next three to four months. The Planning Group met online for the first time on 29 September 2020 and the Group will meet again in November and December. It is planned to recommence full Forum meetings in early 2021.
More generally, many of the Independent Review Group Report’s recommendations dovetail with the Sláintecare programme and are being considered in that context. In addition, some recommendations are being taken forward in the context of the Department of Rural and Community Development’s 'Sustainable, Inclusive and Empowered Communities: A Five-Year Strategy to Support the Community and Voluntary Sector in Ireland 2019-2024'.
500. Deputy Kathleen Funchion asked the Minister for Health the amount of funding allocated for respite services. [30019/20]
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 this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
501. Deputy Joe Flaherty asked the Minister for Health the number of persons who applied to the recruitment campaign for community swabbers in the CHO8 area; the number of community swabbers that have been recruited in the CHO8 area; and if this will enable staff deployed from a centre (details supplied) to return to their jobs. [30036/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy on this matter, as soon as possible.
502. Deputy Joe Flaherty asked the Minister for Health the date on which staff will return from testing duties to their work at a centre (details supplied). [30037/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
503. Deputy Carol Nolan asked the Minister for Health the measures being taken to prioritise the full reopening of day care services for adults with an intellectual disability in counties Laois and Offaly; and if he will make a statement on the matter. [30051/20]
View answerAs part of the overall effort to contain the spread of COVID-19 and in line with public health advice, disability day service locations closed in March. The HSE began planning for the resumption of adult disability day services in May. A group representative of families, service providers and other relevant stakeholders, including Inclusion Ireland, was convened and tasked with the development of a Resumption Plan. On May 31st the Framework for the Resumption of Adult Disability Day Services was published and the guidance to support this framework was published on July 8th.
The guidance is to enable safe and person-centred disability day service supports to be provided in line with current public health advice and infection control guidance. It is not overly prescriptive in terms of detail as there is a wide diversity of disability in the 19,000 adults that received day service supports and day service locations vary enormously in size and capacity. Of this 19,000, approximately 5,000 people receive a day service as part of their residential placement.
The key overarching elements of managing the risk of infection are:
1. Processes to identify people (service users and staff) with communicable infection (including COVID-19) before they access services/attend work or as soon as possible after they access services/attend work
2. Processes to minimize the risk of spread of infection from people (service users and staff) who access services/attend for work with unrecognized infection (Standard Precautions)
3. Early detection of spread of infection in the service and immediate response to limit harm.
The guidance developed to support the resumption of adult day services also has had to take account of social distancing rules which has meant that there is a reduced number of people in each service location. This means that, when day services re-opened through August and September, they re-opened at 40% capacity. However, the HSE is committed to maximising the support that can be provided within these restrictions. The HSE also plan to capture the detail of the service being provided to each individual over the next few weeks, to get a better understanding of the quantum of service being provided.
On Monday 28th September, Ministers Donnelly and Rabbitte announced that €10 million is being made available in 2020 to support the resumption of day services and enhanced home support services for disability service users.
Of this, €7.5 million will increase disability day services by one day a week for over 14,000 adults. This funding is being drawn down from the National Action Plan on COVID-19. Funding requirements for 2021 will be considered as part of the Estimates process.
In line with the Governments Resilience & Recovery Framework (2020 – 2021), the HSE regards the provision of disability services as essential to maintaining a response to people with a disability, in the same way that schools and creches are. Importantly, Government’s intention is that disability services will remain open at each level of the Resilience and Recovery Framework, subject to public health guidance
As the Deputy's question also pertains to a service matter, I have asked the Health Service Executive to reply to the Deputy directly, as soon as possible.
504. Deputy Richard Bruton asked the Minister for Health if provision has been made to provide transport to persons suspected of having Covid-19 who do not have means of transport; and if he will make a statement on the matter. [30053/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
505. Deputy Thomas Gould asked the Minister for Health if provision can be made on compassionate grounds for one visitor in full PPE to a care home under level 3 restrictions if the resident is suffering with mental health issues as a result of visiting restrictions. [30054/20]
View answerI understand that the question raised by the Deputy concerns long term residential settings for people with a disability.
People 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.
Residential settings are people’s homes as well as places where health and social care are provided. It is recognised that the impact of COVID-19 on society in general and especially those living in long-term residential settings has been considerable. During these times there has been a particular emphasis on retaining a holistic view of the well-being 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.
A key aim of the Resilience and Recovery 2020-2021: Plan for Living with COVID-19 is to provide clarity on what restrictive measures are appropriate around the country based on the pattern and progress of COVID-19 in a particular area at a particular time. In line with this Framework, new COVID-19 Guidance on Visitations to Residential Care has been developed by the Health Protection Surveillance Centre (HPSC) to support long-term residential care providers in the discharge of their responsibilities and to support residents to the greatest extent possible, having regard to the challenging times we are living in. The latest guidance, including information on visitations to residential care facilities is available on the HPSC’s website and the latest guidance, updated on 1st October is available here:
www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/guidance/vulnerablegroupsguidance/.
As the Deputy is aware, all counties in Ireland are currently at Level 3 on the National Framework for Living with COVID-19. Under Level 3 of the Framework, it is unfortunately the case that visits to long-term residential settings are paused. I am very much aware of how difficult the current restrictions on visiting are for residents and their families, and we very much hope that a return to less restrictive visiting can be safely facilitated soon.
It is important to emphasise that the guidance is clear that visits should be facilitated in critical and compassionate circumstances. Moreover, in the context of Framework Level 3 a more flexible interpretation of critical and compassionate circumstances is appropriate compared with Framework Level 4 and 5. Furthermore, the term ‘critical and compassionate circumstances’ may include circumstances in which a resident is significantly distressed or disturbed and there is reason to believe that the visit may alleviate that distress or instances where a resident expresses a strong sense of need to see someone.
The guidance further states that virtual visiting, outdoor visiting and what is referred to as ‘window visiting’ need not be restricted at any Framework Level, if there are suitable facilities and capacity to accommodate and support the visit. These options should be facilitated by service providers to the greatest extent possible. It is also essential that all decisions regarding restricted access should be communicated clearly to each resident and to relevant others.
506. Deputy Aengus Ó Snodaigh asked the Minister for Health the steps he has taken to address the misuse of nitrous oxide; and if he will make a statement on the matter. [30057/20]
View answerGovernment policy in relation to drug and alcohol addiction services is set out in the national drugs strategy, Reducing Harm, Supporting Recovery-a health led response to drug and alcohol use in Ireland 2017-2025.
Following recent media reports regarding the increased use of nitrous oxide, a request was made to the Health Service Executive (HSE) to gather evidence on its use nationally through HSE Addiction Managers as well as Drug and Alcohol Task Forces, with whom it shared a ‘trends template’ containing a series of questions in relation to patterns and emerging harms. The HSE also shared a similar series of questions with the Union of Students in Ireland as well as contacting hospitals, and the National Poisons Information Centre in this regard.
On review of the data regarding the prevalence of use of nitrous oxide, at present, it is not represented in traditional data sets such as the general population survey, treatment data, or in the national drug-related death index; there have been no recorded deaths linked directly to the use of this substance.
The National Poisons Information Centre, Beaumont Hospital has received no calls in relation to nitrous oxide between 2015 to the present date, although there has been a small number of web-based queries about the substance. HSE Adolescent Addiction services have not had presentations from individuals seeking help in relation to use of nitrous oxide. Further, hospital sources are not currently reporting a concern in relation to harms associated with use of nitrous oxide.
Following its research, the HSE has concluded that while the use of nitrous oxide has emerged in an Irish context over the past two years, at present there is limited information to suggest emerging harms when compared to other more frequently used substances such as cocaine or MDMA. A locally targeted approach has been recommended within areas of need to address the use of this substance as a large-scale media campaign would be counterproductive if launched without formative research and a strong theoretical basis.
In this context, a number of steps have been taken to address the use of nitrous oxide. The HSE have published and promoted on social media tailored information aimed at parents who are concerned about the use of this substance by young people. New content has been added to the Drugs.ie website, as well as a harm reduction section on nitrous oxide. Nitrous oxide will also be included in new awareness resources being created by the HSE in quarter 4 of 2020.
Further, in support of a targeted response, a number of webinars have been hosted with the aim of upskilling local professionals regarding the use of nitrous oxide. Speakers at these events included a UK professional, the HSE, and professionals from the local areas.
In order to provide further data on its use, nitrous oxide will be included as the Irish module as part of the European Monitoring Centre for Drugs and Drug Addiction EU Web Survey in March 2021.
I believe that particular vigilance is required to protect young people from threats to their health and well-being from misuse of substances, including nitrous oxide. I am committed to continuing to resource harm reduction and education campaigns aimed at increasing awareness of the risks of drug use.
507. Deputy David Cullinane asked the Minister for Health the date on which the National Adult Critical Care Capacity and Activity Census Report 2020 will be published. [30062/20]
View answerThe report the Deputy refers to is prepared by the Critical Care Programme of the HSE. As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly.
508. Deputy David Cullinane asked the Minister for Health the status of the use of Citywest; his plans to extend the contract; his plans for its future use; and if he will make a statement on the matter. [30067/20]
View answer525. Deputy David Cullinane asked the Minister for Health the costs to date associated with Citywest; the projected future costs; the current and proposed future uses; and if he will make a statement on the matter. [30141/20]
View answerI propose to take Questions Nos. 508 and 525 together.
Background:
In response to the Covid-19 pandemic, the HSE committed to the provision of a National Self -Isolation Facility, to provide a service for people affected by Covid-19 (confirmed or suspected cases, or close contacts of confirmed cases) who have the capacity for self-management, are required to self-isolate, but are unable to do so. In response to this need, the HSE Self-Isolation Facility at the Citywest Hotel opened to admissions on April 1st 2020, under the governance of HSE Community Operations (Primary Care). The purpose of the unit is to provide a safe environment for residents to self-isolate, and to minimise the risk of community transmission of Covid-19. Referrals to the facility are made by a discharging hospital, GP, Public Health Doctor, contact tracing team or other appropriate medical physicians.
In conjunction with the self-isolation facility at Citywest Hotel, the Hotel Convention Centre was converted into a 300 bed overflow step down facility for patients who have had the virus but are recovering, to alleviate pressure on hospitals in the greater Dublin area. Similar step-down facilities were also established in Limerick and Galway. Thankfully, the pressure on our acute hospitals did not require this facility in Citywest to be brought into operation.
The existing licence agreement for the use of the Citywest Hotel and Convention Centre is expiring and will need to be renewed by the end of October 2020, or the premises returned to its original condition and vacated. Costs incurred to date for Citywest have been €24.7m (April to October 2020).
Current Position:
The national self-isolation facility at Citywest remains operational with admissions continuing. In addition, the HSE Healthcare Worker Self Isolation pathway at Citywest opened for admissions on 1st June 2020. This service is provided for Healthcare Workers who are employed by, or are contracted to commence employment within the HSE, HSE funded agencies or any agency providing healthcare services in Ireland, who are required to self-isolate on arrival into the country prior to commencing employment.
A significant testing (swabbing) centre is now also operational at the site since mid-September governed by HSE South West Dublin area (CHO7). This testing centre in its current configuration and staffing levels is delivering 750-800 tests per day.
In additional, the following services, supported by Acute Operations are now operating from the Convention Centre under existing licence arrangements to ensure utilisation of the facility and to assist the reduction of patient waiting lists:
IEHG Glaucoma Testing:
An IEHG led drive through glaucoma testing clinic is operational which proposes to treat 2,000 patients prior to the expiry of the current licence arrangement.
CHI Allergy Testing:
CHI and CUH commenced ‘Food Challenges’ allergy testing on 7th September 2020. It is anticipated that they will treat 400 patients during a six-week period prior to the expiry of the current licence arrangement.
CHI Orthoptist Clinic:
CHI commenced Orthoptist led clinics on 7th September 2020 to treat a waiting list of approximately 500 patients whose appointments were cancelled due to Covid-19 restrictions.
Going Forward:
The HSE is committed to the provision of a National Self-Isolation Facility in response to the Covid-19 pandemic and are actively working on contingency measures to ensure the on-going provision of Self-Isolation facilities through 2020 and into 2021 to meet continuing and potential future demand for this service.
Based on activity to date, the HSE requires on-going access to a baseline capacity of 200 beds, with contingency to increase capacity beyond this level in response to increased Covid-19 infection rates; access to a contingent capacity such as that which exists in Citywest is particularly relevant in planning for the outcomes of serial testing in Direct Provision Centres and Food Manufacturing which has the potential to create a greater level of demand for Self-Isolation Facilities. Negotiations with hotel owners, Tetrarch Capital, regarding a new contract are complete and the HSE are currently in the process of submitting a sanction request, to enter a new contract, to the Department of Health for review.
510. Deputy Paul McAuliffe asked the Minister for Health the quantity of the winter 'flu vaccination purchased; his plans for additional quantities to be purchased; and if he will make a statement on the matter. [30071/20]
View answerGiven the potential for the winter flu season in 2020/2021 to coincide with a resurgence of COVID, and the importance of minimising hospital attendance, the Government is expanding the provision of vaccination without charge to all of those in the at-risk groups, including healthcare workers, and to all children aged from 2 to 12 years inclusive. The programme is being offered through GPs.
1.35 million doses of the Quadrivalent Influenza Vaccine have been ordered this year, to be made available to all persons in an at-risk group aged from 6 months up. 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 children aged from 2 to 12 years.
Orders for flu vaccines are placed early in the year for the following winter season, due to the necessary lead-times for manufacturing the vaccines, and at the moment the international market for vaccines is under pressure and is not able to supply significant additional quantities of the vaccine. However, 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. Some GPs have also commenced the vaccination programme for children.
Those not covered by the HSE programme can avail of vaccination on a private basis. I understand that stocks of vaccine for private administration are now being distributed. The Health Products Regulatory Authority has not been informed of shortages of vaccines.
511. Deputy Paul McAuliffe asked the Minister for Health his plans to incentivise pharmacists to carry out off-site vaccination clinics; and if he will make a statement on the matter. [30072/20]
View answerThe 2020/2021 influenza vaccination season will be the 10th year that pharmacists have provided this service to patients. Since the pharmacy vaccination service began, the pharmacy regulator, the Pharmaceutical Society of Ireland (the PSI) have carried out a number of evaluations and a user satisfaction survey which have identified that this service is well received by the public and is provided to a high standard.
It was therefore considered appropriate to build on the existing good practice and patient trust to further develop this service, in order to meet the evolving healthcare needs of the public and support the national healthcare system, particularly during this time of a pandemic.
Due to the impact of COVID-19, there is a public health need to increase access to the influenza vaccine. I, as Minister for Health, have signed into law Statutory Instrument No. 401 of 2020 - Medicinal Products (Prescription and Control of Supply) (Amendment) (No. 5) Regulations 2020. These Regulations amend the Medicinal Products (Prescription and Control of Supply) Regulations 2003 to allow for influenza vaccination to be administered by registered pharmacists in places other than the premises of the retail pharmacy business in which they carry on their professional practice.
This has the potential to greatly increase uptake of the influenza vaccine in all the groups, who can avail of the vaccine free of charge in particular those in the at-risk categories, as well as patients wishing to access this service privately. It also enables pharmacists who may be unable to provide a vaccination service on their pharmacy premises during the 2020/21 flu season, (due to requirements for social distancing/staff restraints etc.) to continue to provide this service for their patients and local community, albeit at a different, but safe location.
Given the importance of maximising the level of uptake in the flu vaccination, my Department, in conjunction with the HSE and following discussion with the IMO and IPU, has agreed to a process to enable and incentivise GPs and pharmacists not only to deliver vaccination to the expanded groups, but to actively seek out relevant patients and deliver vaccinations in a programmatic way, such as through dedicated flu vaccination clinics. This approach is considered necessary and appropriate so as to replace the more opportunistic vaccination approach of previous years with a much more proactive one. The ability to allow for vaccination to be administered by pharmacists in places other than the premises of the retail pharmacy business in which they carry on their professional practice is considered to be an enabler of this approach.
However, it is not the role of the Minister for Health to set up off-site influenza vaccination clinics led by pharmacists or any other healthcare professional, rather this is demand led and arranged locally as the need arises, in lines with applicable regulatory requirements and clinical and practice guidelines.
513. Deputy Pa Daly asked the Minister for Health if supplemental Covid-19 funding will be provided in budget 2021 for an adult day service (details supplied) to enable a full return to services; and if he will make a statement on the matter. [30088/20]
View answerOn Monday 28th September, Ministers Donnelly and I announced that €10 million is being made available in 2020 to support the resumption of day services and enhanced home support services for disability service users. Of this, €7.5 million will increase disability day services by one day a week for over 14,000 adults. This funding is being drawn down from the National Action Plan on COVID-19.
In relation to the actions under the remit of my Department, the level of funding available is being considered as part of the national Estimates and budgetary process for 2021 which is currently underway. Pending completion of this process it is not appropriate for me to comment further at this stage.
514. Deputy Pauline Tully asked the Minister for Health the funding allocation for respite services in the budgets in each of the years 2015 to 2018, inclusive; the expenditure on respite services in the years 2016 to 2019, inclusive; and if he will make a statement on the matter. [30089/20]
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 this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
515. Deputy Aengus Ó Snodaigh asked the Minister for Health if his attention has been drawn to the fact that children as young as six years of age with medical cards are being refused dental treatment (details supplied). [30098/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
516. Deputy Denis Naughten asked the Minister for Health the number of applications for primary medical certificates that were approved in 2019 and for the first six months of 2020, by county or CHO basis; and if he will make a statement on the matter. [30104/20]
View answerThe Minister for Finance has responsibility for the Disabled Drivers and Passengers (Tax Concessions) Scheme, which is operated by the Revenue Commissioners. To qualify for the Scheme, an applicant must be in possession of a Primary Medical Certificate.
The extent of the involvement of Health Service Executive (HSE) personnel in the Scheme relates to making a professional clinical determination as to whether an individual applicant meets the specified medical criteria. This determination is undertaken by Senior Medical Officers for the relevant HSE Community Health Organisation, on behalf of the Department of Finance and the Revenue Commissioners.
As the Deputy's question relates to a service matter, I have arranged for the question to be referred to the HSE for direct reply to the Deputy.
