Written Answers Nos. 1278-1295
1278. Deputy Holly Cairns asked the Minister for Health the restrictions on partners and-or accompanying persons attending for labour and prenatal appointments in the maternity services under levels 4 and 5 of the Living with Covid plan; and if he will make a statement on the matter. [32904/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1279. Deputy Holly Cairns asked the Minister for Health if garden centres are allowed to operate under levels 4 and 5 of the Living with Covid plan; and if he will make a statement on the matter. [32905/20]
View answerYou will be aware that the situation regarding COVID-19 has been, and continues to be, an evolving situation. COVID-19 is still having a major impact both here in Ireland and elsewhere.
On Tuesday 15 September the Government published ‘Resilience and Recovery 2020-2021: Plan for Living with COVID-19’. This new Plan outlines our medium-term strategy for COVID-19 and sets out a Framework of 5 Levels which outline the broad measures which will apply depending on the level of the virus at any given time. It will be possible for different regions and counties to be at different levels, depending on prevailing epidemiological situation . The Plan is designed to help everyone – individuals, organisations and sectors – to better understand, anticipate and prepare for the measures that might be introduced to contain transmission of the virus. The intention is that Departments and sectors will provide guidance for specific sectors and activities in line with the 5 level framework.
Under Level 4 of the Plan, essential retail and businesses which are primarily outdoors are permitted to open and therefore at Level 4 garden centres are permitted to open.
At Level 5 of the Plan, only essential retail is permitted to open and all other retail is closed and therefore at Level 5 garden centres are not permitted to open.
The public health advice relating to Covid-19 is kept under continuing review by the National Public Health Emergency Team (NPHET), and it provides advice to Government in line with the current epidemiological position. The latest public health advice on these matters is available at the links below and is updated on a regular basis:
https://www.gov.ie/en/organisation/department-of-health/
https://www2.hse.ie/coronavirus/
https://www.gov.ie/en/
1282. Deputy Joe McHugh asked the Minister for Health if he will consider the nomination of one family member to continue visiting loved ones in nursing and care homes if that said family member restricts their movements; and if he will make a statement on the matter. [32915/20]
View answerOn the 1 October the Health Protection Surveillance Centre’s (HPSC) new COVID-19 Guidance on visitations to Long Term Residential Care Facilities was published. The revised guidance followed a substantial review process.
This guidance aligns with the 5 level framework of restrictive measures as outlined in the Government’s Living with COVID-19 Plan, to support long-term residential care providers in the discharge of their responsibilities and to support in the safe visiting, to the greatest extent possible, having regard for the challenging times in which we are living.
The new guidance provides a clear and open framework for visiting. It provides guidance on the measures required to be adopted by nursing homes and by visitors to mitigate risks associated with visiting. In circumstances where the level of the virus circulating in the community is high, there is greater risk to nursing homes and other vulnerable settings and people. It is of great concern that heightened community transmission will bring further unwitting transmission of COVID-19 into nursing homes impacting on those most vulnerable to the virus. In response to the overarching situation, the Government took the decision to move the whole country to level 5 of the Framework of Restrictive measures from 21st October. This was a significant decision. The purpose of these measures is to respond to the current situation, break the chains of transmission and reduce the amount of the virus circulating in the community. With regard to visits to nursing homes, the public health advice in relation to Level 5 is clear – that visits should be suspended aside from critical and compassionate circumstances.
The advice also re-emphasises that in circumstances where visiting may need to be restricted or suspended in nursing homes for the protection of residents and staff, alternative arrangements such as “window visiting” is acceptable across all 5 levels of the framework of restrictive measures, providing a nursing home can safely facilitate them, and that arrangements should be in place to support virtual visiting (telephone or video-link) to the greatest extent possible.
As I have previously publicly stated, I encourage all nursing homes to remain familiar with the latest public health advice and support, and to make every effort to continue to facilitate visitors in line with public health advice. While many nursing homes have shown great, innovative practice throughout the pandemic, I continue to urge all nursing homes to have plans in place for innovative, safe alternative visiting and communication arrangements for residents and their families and friends, during periods of enhanced protective measures. The importance of continued social interaction of residents and their families cannot be understated and every effort should be made, in line with public health advice, to ensure that these interactions continue, including through window visits.
On 22 September I wrote to all nursing home providers with regard to the COVID-19 Nursing Homes Expert Panel’s recommendations, with a particular focus on communication, both in terms of the ongoing situation and visiting protocols.
Officials in my Department have also written separately to the national representative body for nursing homes, encouraging providers to maintain familiarity with the latest public health advice and support, to make every effort to continue to facilitate and ensure that nursing home residents receive visitors in critical and compassionate circumstances, in line with public health advice, and to communicate with family and friends on an ongoing basis in order to support positive mental health and wellbeing. These measures are in place to safeguard the health of residents in these facilities, and also the health of those staff that provide care and support to residents.
1283. Deputy Cian O'Callaghan asked the Minister for Health if agency staff working for a State agency (details supplied) have been provided with the same level of Covid-19 protections as permanent staff, including the option to work from home; and if he will make a statement on the matter. [32919/20]
View answerI would like to advise the Deputy that the Department of Public Expenditure and Reform has prepared and circulated a Guidance document for public service employers and employees in relation to HR matters during Covid. This guidance applies throughout the public service, including the Nursing and Midwifery Board of Ireland (NMBI). This document can be viewed at the following link: https://www.gov.ie/en/news/092fff-update-on-working-arrangements-and-leave-associated-with-covid-19-fo/.
The NMBI have advised my Department that it provides the same level of Covid-19 protections to all staff whether they are permanent, contract or agency workers.
The NMBI provide essential support services to the health sector. There are a number of functions, for example, elements of the applications and registrations of nurses and midwives, which require staff to be on-site to deal with manual elements of the applications. This cohort includes both permanent and agency staff.
In the business functions that do not require on-site support, staff, including agency workers, have been provided with the necessary IT infrastructure and are working from home.
1284. Deputy Michael Healy-Rae asked the Minister for Health if an appointment will be expedited for a person (details supplied); and if he will make a statement on the matter. [32923/20]
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.
Patient safety remains at the centre of all hospital activity and elective care scheduling. To ensure services are provided in a safe, clinically-aligned and prioritised way, hospitals are following HSE clinical guidelines and protocols.
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.
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.
1285. Deputy Patrick Costello asked the Minister for Health the reason applicants with clinical experience and qualifications are considered for Covid-19 work, with specific reference to non-clinical tracers' applications for the HSE Be on Call for Ireland programme; and if he will make a statement on the matter. [32929/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1286. Deputy Francis Noel Duffy asked the Minister for Health the breakdown of the €10 million funding allocated for the national drugs strategy; the amount of funding allocated to drug and alcohol task forces; if additional funding will be allocated to local drug task forces currently providing front-line services; and if he will make a statement on the matter. [32931/20]
View answerBudget 2021 allocated €10m in new developments for drugs policy and inclusion health. Of this, €4m is being provided to enhance drug and alcohol services as follows:
- €1m to develop targeted drug and alcohol initiatives through the network of drug and alcohol task forces, and to increase in core funding for existing services
- €2m to increase residential treatment services for people with severe drug and alcohol dependency across the country, including a step-up stabilisation facility in CHOs Cork/Kerry, Mid-West and South East and a low threshold programme in Dublin North East Inner City
- €560,000 to expand community and family support services, including initiatives in Donegal/Leitrim/Sligo, Louth/Meath and Dublin North Inner City
- €390,000 for drug prevention and information initiatives, including pilot drug monitoring at festivals and the night-time economy and expanded access to the drugs and alcohol helpline
A further €4m is allocated to address the addiction and mental health needs of people who are homeless.
€2m in new funding is being provided to enhance access to health services for socially excluded groups.
The additional €1m for targeted drug and alcohol initiatives will be directed towards new and emerging needs, informed by the mid-term review of actions in the national drugs strategy, and delivered in conjunction with drug and alcohol task forces. I will announce details of the new funding in due course.
1287. Deputy Carol Nolan asked the Minister for Health if he will consider extending the 5 km travel limit for persons who live in rural areas in view of the unreasonable restrictions this will place on persons who reside in isolated or low-population density areas; and if he will make a statement on the matter. [32933/20]
View answerOn Tuesday 15 September the Government published ‘Resilience and Recovery 2020-2021: Plan for Living with COVID-19’. This Plan outlines our medium-term strategy for COVID-19 and sets out a Framework of 5 Levels which outline the broad measures which will apply depending on the level of the virus at any given time. The Plan is designed to help everyone – individuals, organisations and sectors – to better understand, anticipate and prepare for the measures that might be introduced to contain transmission of the virus.
Restrictions on domestic travel apply at Levels 3, 4 and 5 of the Plan. At Level 5 of the Plan, people are asked to stay at home and to exercise within 5km of home. It is appreciated that these measures are difficult, but they have been put in place to protect public health.
A number of exemptions are provided, including for travel to and from work, where work involves providing an essential service; to attend education; to attend medical appointments and collect medicines and other health products; to travel to attend disability day services; to travel to attend a court; for food shopping; to take school aged children to permitted training; for vital family reasons, such as providing care to children, elderly or vulnerable people; for farming purposes; to attend a wedding or funeral and to visit a grave. In addition, those living alone or with a dependent adult may form a support bubble with one other household. This household can be outside the 5km limit. Further details are available here: https://www.gov.ie/en/publication/3516d-support-bubbles.
The public health advice relating to Covid-19 is kept under continuing review by the National Public Health Emergency Team (NPHET), and it provides advice to Government in line with the current epidemiological position.
Details of Level 5 measure are available here: https://www.gov.ie/en/publication/2dc71-level-5/.
Current regulations and other Statutory Instruments related to the Covid-19 pandemic are available here: https://www.gov.ie/en/collection/1f150-view-statutory-instruments-related-to-the-covid-19-pandemic/.
1288. Deputy Denis Naughten asked the Minister for Health if the Covid-19 response team has been assembled; the make-up of the team by profession; if the team is active; if it has been called into use; and if he will make a statement on the matter. [32937/20]
View answerResidents of nursing homes are vulnerable because of their age, underlying medical conditions, the extent of their requirement for direct care involving close physical contact and the nature of living in congregated settings. Nursing homes have been particularly impacted by COVID-19 both in Ireland and internationally.
The central focus of the response to COVID-19 has been to control the spread of the virus in so far as possible to protect those who are most vulnerable from infection, as well as protecting against causes, situations, circumstances, and behaviours that may lead to the spread of COVID-19.
Sustained communication and interagency cooperation also remain central to the response to COVID-19. The State’s responsibility to respond to the public health emergency created the need for the HSE to set up a structured nursing home support system in line with NPHET recommendations.
This package of supports has been a critical intervention in supporting the resilience of the sector in meeting the unprecedented challenges associated with COVID-19. Guidance, PPE, staffing, serial testing, infection prevention and control training, accommodation and financial support have been provided to the nursing home sector, both public and private. In addition, multi-disciplinary clinical supports are in place at CHO level through 23 COVID-19 Response Teams, which were established earlier this year as well as outbreak control teams responding to outbreaks. I have asked the HSE to reply to the Deputy in relation to operational matters of the COVID-19 Response Teams.
1289. Deputy Fergus O'Dowd asked the Minister for Health if he will respond to and clarify guidance on visitors to nursing homes (details supplied); and if he will make a statement on the matter. [32939/20]
View answerOn Tuesday 15 September the Government published ‘Resilience and Recovery 2020-2021: Plan for Living with COVID-19’. This Plan outlines our medium-term strategy for COVID-19 and sets out a Framework of 5 Levels which outline the broad measures which will apply depending on the level of the virus at any given time. The Plan is designed to help everyone – individuals, families, organisations and sectors – to better understand, anticipate and prepare for the measures that might be introduced to contain transmission of the virus.
At Levels 3, 4 and 5 of the Plan, Long Term Residential Care Facilities visiting is suspended, aside from critical and compassionate circumstances.
HPSC guidance makes clear that 'window visiting' where a person stands outside and speaks to a person at safe distance through an open window or by telephone is acceptable at any Framework Level and during Outbreaks.
While people are asked to stay at home and exercise within 5km of home at Level 5, exemptions are permitted in a number of situations including for vital family reasons. This is provided for under Regulation 5 (2)(j) of SI 413 of 2020. This can include nursing home visits (including for window visits).
Further information on visiting safely can be found in the HPSC guidance: https://www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/guidance/infectionpreventionandcontrolguidance/residentialcarefacilities/Guidance%20on%20visitations%20to%20LTRCF.pdf.
1290. Deputy Niamh Smyth asked the Minister for Health the reason a person (details supplied) is unable to receive additional home help hours; and if he will make a statement on the matter. [32946/20]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1291. Deputy Brendan Griffin asked the Minister for Health if food supplements and gluten-free products will be covered under the medical card scheme in view of the fact that these products can be expensive; and if he will make a statement on the matter. [32956/20]
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.
1292. Deputy Cathal Crowe asked the Minister for Health the contingency plans in place to deal with the already extensive waiting lists for patients with arthritis for rheumatology appointments and so on as the country enters another period of restrictions. [32963/20]
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 urgent time-critical 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.
Patient safety remains at the centre of all hospital activity and elective care scheduling. To ensure services are provided in a safe, clinically-aligned and prioritised way, hospitals are following HSE clinical guidelines and protocols.
In terms of the current provision of treatment to patients, the HSE has advised the Department that hospitals continue to offer appointments and treatments to patients. The HSE website provides details on services currently available and operational in each hospital. This is frequently updated by the HSE.
The HSE continues to optimise productivity through alternative work practices such as the use of alternative settings including private hospitals, community facilities and alternative outpatient settings.
The National Treatment Purchase Fund (NTPF) is currently reviewing strategies to maximise activity and benefit for patients, to include, increased use of private hospitals, funding weekend and evening work in public hospitals, funding “see and treat” services where minor procedures are provided at the same time as outpatient consultations, funding hybrid services where public and private hospitals contribute to the treatment of patients, virtual clinics and clinical validation.
The NTPF have advised my Department that they have approved 8 outpatient rheumatology initiatives for funding in 2020. These initiatives will facilitate treatment for over 3,500 patients on rheumatology waiting lists throughout the country.
1293. Deputy Carol Nolan asked the Minister for Health if additional funding has been assigned in budget 2021 to address the digital divide to ensure that persons with disabilities and other disadvantages are not left behind during the pandemic; and if he will make a statement on the matter. [32976/20]
View answerIn relation to health services, Health Service Executive (HSE) Disability Services provide personal and social care supports based on the needs of the individual, rather than the provision of services based on a specific diagnosis or condition.
While addressing 'digital divide' among people with disabilities and other disadvantaged groups across society is much broader than the remit of the Department of Health, you will be interested to note that the HSE have established a Digital and Assistive Technology (DAT) Group since June 2020, chaired by Dr MacLachan, Clinical Lead for Disabilities. The long term aim of the group is to develop guidelines and influence national health policy on the use of DAT to enhance the lives of people with disabilities. I have also arranged for your question to be referred to the HSE for consideration and direct reply to you.
Separately, Budget 2021 provided for once-off funding in 2020 for voluntary disability service providers to advance the Transforming Lives reform process, under the Strengthening Disability Services Scheme. The scheme is open to voluntary not-for profit organisations of any size who provide disability services under a Service Agreement or Grant Agreement with the HSE. An organisation may get a grant of up to 1% of their 2019 HSE funding.
There are three strands under which eligible providers may apply for funding. Digital supports may be considered under strand 1 of the initiative: for example
- Purchase of assistive technology including IT for service users to enhance independence
- Purchase or development of apps that help those receiving services remotely
The closing date for consideration of applications under all strands is 18th November.
1294. Deputy Carol Nolan asked the Minister for Health if additional support will be provided for specialist training providers for persons with disabilities such as National Learning Network; and if he will make a statement on the matter. [32977/20]
View answerIn the Programme for Government, we made extensive commitments to improve the lives of people with disabilities and in doing so, we signalled to those with a disability that we are serious about making a difference. In the first budget of this government, I’m pleased that we have secured significant additional funding to start delivering on those commitments.
We will be investing an additional €100 million in new initiatives in 2021, bringing the total disabilities budget to around €2.2 billion. The increased level of funding in 2021 will build on initiatives currently underway, as well as introducing new ones.
I will be targeting the new funding at five key areas: children’s services, day services, community supports, residential services, and integration. I will now ask the HSE, in preparing its National Service Plan, to examine how these key priorities can be progressed in 2021 within the overall increased envelope of funding for disability services
In addition to the investment outlined in Budget 2021, €20 million is being made available on a once off basis in the current year to support voluntary disability service providers engaged in the Transforming Lives Reform programme. Further information, including eligibility criteria and how to apply, can be found here: https://www.gov.ie/pdf/?file=https://assets.gov.ie/94127/10ffcbd0-b0f7-425c-b8c8-ad27d93e4600.pdf#page=null.
1295. Deputy Carol Nolan asked the Minister for Health if a commitment will be given to fully implementing the report on the role of voluntary organisations in the provision of public disability services and to providing sufficient funding to address pay inequality among section-39 workers; and if he will make a statement on the matter. [32979/20]
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 the 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’.
With regard to Section 39 organisation pay restoration, a Workplace Relations Commission (WRC) agreement reached in October 2018 provided for pay restoration in relation to 50 pilot organisations in the first instance. Pay restoration for these bodies commenced in April 2019 with further payments due in October 2020 and October 2021 as appropriate. The agreement recognised that some of the remaining Section 39 organisations were also likely to have pay restoration issues and a process to address these issues commenced in 2019 under the auspices of the WRC. Despite the engagement which took place, it has not yet been possible to reach agreement. This is because management cannot provide a timeframe or a commitment to fund this part of the process.
The HSE are currently costing this next phase of pay restoration and are expected to complete the exercise in the coming weeks. Engagement will take place with the Department of Public Expenditure and Reform once the HSE has completed this work. Health sector management remain committed to the process.
