Tuesday, 20 Oct 2020

Hospital Appointments Status

Questions (744)

Kathleen Funchion

Question:

744. Deputy Kathleen Funchion asked the Minister for Health when a person (details supplied) will receive an appointment for occupational therapy. [31630/20]

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Written answers

Minister of State at the Department of Health

The 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.

Hospital Appointments Status

Questions (745)

Kathleen Funchion

Question:

745. Deputy Kathleen Funchion asked the Minister for Health the status of operations for a person (details supplied). [31634/20]

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Written answers

Minister for Health

It 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 Organization.

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.

Medical Inquiries

Questions (746)

Kathleen Funchion

Question:

746. Deputy Kathleen Funchion asked the Minister for Health the procedure to be followed when a teenager consistently presents at an accident and emergency department with headaches; and if a MRI scan is offered as standard procedure. [31635/20]

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Written answers

Minister for Health

As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.

HSE Data

Questions (747)

Kathleen Funchion

Question:

747. Deputy Kathleen Funchion asked the Minister for Health the number of occupational therapists, physiotherapists and speech and language therapists available for both assessments and follow-up appointments for children in counties Carlow and Kilkenny; the wait time for assessments; the wait time for follow-up services; and the number of each type of therapist that have been reassigned to contact tracing for Covid-19. [31638/20]

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Written answers

Minister of State at the Department of Health

The 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.

Hospital Data

Questions (748)

Seán Sherlock

Question:

748. Deputy Sean Sherlock asked the Minister for Health the number of ICU beds free in hospitals in County Cork; and if measures are being implemented to ensure ICU beds are free for non-Covid-19 emergencies. [31643/20]

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Written answers

Minister for Health

At the start of the year, permanent adult critical care capacity in Ireland stood at 255 beds, according to the National Office of Clinical Audit. This included 204 Level 3 ICU beds and 51 Level 2 HDU beds. As part of the initial response to the pandemic, funding was provided for an additional 40 adult critical care beds in March 2020 as well as two paediatric beds. The HSE has advised that between 280 and 285 critical care beds are currently open, with the number open any given day subject to fluctuation in respect of available staff and other operational considerations.

Where necessary, the number of critical care beds can surge beyond the baseline of 280-285 as part of an emergency response. However, it is essential to understand that the use of surge capacity for critical care is necessarily tied to a reduction of services in other areas of the hospital. Moreover, the clinical advice is clear that the greater the reliance on surge ICU capacity, the greater the clinical risk with potential impact on patient outcomes.

Our critical care units have coped well so far, largely due to the fact that the curve was flattened successfully in early stages. As a result, our outcomes for Covid patients in ICU have compared well with other jurisdictions including the UK.

Budget 2021 will allocate funding totalling €52m in 2021 to critical care. This will retain, on a permanent basis, the 42 critical care beds put in place on a temporary basis this year and add significant new capacity. Funded adult critical care beds will increase to 321 by end 2021, an increase of 66 over the baseline number of 255 funded beds in 2020. Funding for 2021 will also include money to allow for the development of a workforce plan as well as education initiatives to grow the critical care workforce.

In relation to the specific information requested by the Deputy, I have asked the HSE to respond directly to him.

Nursing Home Inspections

Questions (749)

Róisín Shortall

Question:

749. Deputy Róisín Shortall asked the Minister for Health the progress that has been made to date towards increasing the frequency of nursing home inspections as recommended in the nursing homes expert panel report, which recommended the immediate increase from the base of 22 inspectors overseeing 576 facilities with a visit frequency of 18 months; the action that is planned; the timeline for same; and if he will make a statement on the matter. [31648/20]

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Written answers

Minister of State at the Department of Health

The COVID-19 Nursing Homes Expert Panel’s report was published on 19 August 2020. It includes 86 recommendations in total, over 15 thematic areas, with associated timelines for implementation over the short, medium and long term.

The Minister for Health established an oversight structure to progress the important recommendations contained in this Report. This encompassed the establishment of both an Implementation Oversight Team and a Reference Group. There is a key focus on the implementation of recommendations that require immediate action to ensure ongoing preparedness as we move into the winter months.

HIQA recently submitted a business case to the Department, outlining the current impact on regulatory activity, the current designation of resources, and the expected increase in resources necessary to continue to deliver on its statutory role as regulator to year end and into next year.

Based on the impacts on regulatory activity by HIQA, the Department has approved funding providing for 7 additional inspectors, and additional support staff to assist the inspectorate. HIQA has commenced the recruitment process. This action contributes towards the implementation of recommendation 14.3 of the Nursing Homes Expert Panel Report. Additionally, following further analysis of the Expert Panel’s report, HIQA has submitted a further business case to support the implementation of the Panel’s recommendations. The Department is examining this in detail, having regard to the outcome of Budget 2021.

HIQA takes a risk-based approach to regulation which means that it makes decisions based on the information that it has. As such, it prioritises regulatory activity and organises its approach to monitoring, inspection and enforcement, based on the assessment of the risk that the regulated services pose. In this context the regulator tailors its regulatory responses, including the frequency of inspections, so that they are proportionate to the relevant risks.

National Drugs Strategy

Questions (750)

Róisín Shortall

Question:

750. Deputy Róisín Shortall asked the Minister for Health when funding to support the delivery of community action on alcohol announced in budget 2021 will be made available; the way the funding will be distributed; and if he will make a statement on the matter. [31649/20]

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Written answers

Minister of State at the Department of Health

The national drugs strategy, Reducing Harm Supporting Recovery, provides an integrated public health approach to drugs and alcohol use.

The Department is developing a new education and prevention funding scheme which will be launched towards the end 2020. This scheme will include the use of evidence-based approaches to mobilising community action on alcohol.

I want to strengthen the delivery of substance use education across all sectors in order to prevent the use of drugs and alcohol at a young age and to increase awareness of the risks of drug and alcohol use.

Question No. 751 answered with Question No. 698.

Medical Cards

Questions (752)

Éamon Ó Cuív

Question:

752. Deputy Éamon Ó Cuív asked the Minister for Health when the income eligibility levels for qualification for a medical card for those over 70 years of age will be increased as was provided for in legislation passed by the Houses of the Oireachtas in July 2020; and if he will make a statement on the matter. [31655/20]

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Written answers

Minister for Health

The Health (General Practitioner Service and Alteration of Criteria for Eligibility) Bill 2020, enacted on 2nd August 2020, provided for an increase to the gross medical card income limits for those aged 70 and over to €550 per week for a single person and to €1,050 per week for a couple.

The Government recently approved the necessary funding required to implement this measure and the new increased income limits will take effect from 1st November 2020.

Officials in my Department are therefore now making the necessary arrangements to commence the relevant section of the Act and are engaging with the HSE's National Medical Card unit to ensure all operational arrangements are in place for implementation of this measure.

Hospital Data

Health Services Staff

The HSE is now finalising the future service model for testing and contact tracing. This model will aim to deliver a patient-centred, accessible, consistent, flexible service, with a permanent dedicated workforce.

The HSE has adopted RNA PCR as the gold standard test for diagnosing Covid-19 cases, as part of the HSE test and trace strategy, consistent with international best practice, and approved by NPHET. This platform is deployed in acute hospitals, the NVRL and HSE’s commercial partners. Given the volumes required, these operate as batch tests and hence take a number of hours depending on the platform and the volume being processed. The vast majority of Covd-19 tests carried out to date are PCR tests.

Regarding rapid PCR testing equipment, the HSE advises it has access to about 3,000 rapid PCR tests per week, all of this is used in acute settings for high priority, accidents, critical care. It is not used for any priority groups, but rather hospital priority cases which require urgent turnaround, and is designed for small batches of 1-16 tests. The HSE is constantly trying to increase supply of rapid PCR tests.

Many of the rapid non-PCR Covid tests reported in the media which purport to offer a test result in minutes may lack the sensitivity and specificity required for healthcare. However, this issue continues to be monitored by WHO, ECDC, HIQA, and the HSE Laboratory taskforce.

NPHET will continue to consider and review, based on public health risk assessments, how best to target testing to hunt the virus in populations where it’s most likely and where it will do most harm. For example, very few other countries have carried out such mass testing in Long Term Residential Care facilities. The HSE has also carried out serial testing in meat and food processing facilities, Direct Provision Centres, and schools.

In terms of different types of testing, NPHET is also considering the findings of a rapid Health Technology Assessment (HTA) of alternatives to laboratory-based PCR testing to diagnose current infection with SARS-CoV-2. This HTA will be used to inform the national testing strategy, specifically in relation to the potential use of rapid tests in Ireland.

A number of key considerations will need to be taken into account in relation to the deployment of any rapid test for SARS-CoV-2 including test accuracy and performance in the specific test setting, disease prevalence, training, resourcing, operational factors, governance structures, quality assurance, clinical oversight, as well as integration with the contact tracing system and overall national testing strategy.

Covid-19 Pandemic

Questions (762)

Verona Murphy

Question:

762. Deputy Verona Murphy asked the Minister for Health if he will provide a breakdown of confirmed Covid-19 cases in County Wexford for September and October 2020, by cases displaying symptoms and cases not displaying symptoms; and if he will make a statement on the matter. [31696/20]

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Written answers

Minister for Health

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Covid-19 Tests

Questions (763)

Verona Murphy

Question:

763. Deputy Verona Murphy asked the Minister for Health the number of close contacts tested for Covid-19 through the tracing system in County Wexford for September and October 2020; and if he will make a statement on the matter. [31697/20]

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Written answers

Minister for Health

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.