Written Answers Nos. 1368-1385
1368. Deputy Róisín Shortall asked the Minister for Health if his attention has been drawn to differing implementation of the Health Protection Surveillance Centre’s Covid-19 guidance on visitations in long-term residential care facilities (details supplied); the way in which he plans to address varying adherence to the guidelines; and if he will make a statement on the matter. [33406/20]
View answerIn a broader sense, visits to nursing homes are governed by legislation under the Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2013
Regulation 11 provides that:
(1) The registered provider shall make arrangements for a resident to receive visitors.
(2) The person in charge shall ensure that—
(a) in so far as is reasonably practicable, visits to a resident are not restricted, unless—
(i) such a visit would, in the opinion of the person in charge, pose a risk to the resident concerned or to another resident, or
(ii) the resident concerned has requested the restriction of visits.
(b) having regard to the number of residents and needs of each resident, suitable communal facilities are available for a resident to receive a visitor, and, in so far as is practicable, a suitable private area, which is not the resident’s room, is available to a resident to receive a visitor if required.
It is the legal responsibility of each provider to assess the risk associated with visits whilst having regard to the legislation. It is therefore a matter for each provider to consider the risks and mitigation measures associated with their service. Public health guidance has been developed in order to assist and support providers in this regard.
On 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. It 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 well-being. 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.
Current guidance and the recommendations of the Expert Panel report seek to enhance standardisation and consistency in service delivery, including in areas such as visiting and communication.
1370. Deputy Neale Richmond asked the Minister for Health if consideration has been given to waiving parking fees for front-line staff in hospitals in view of the level 5 restrictions; and if he will make a statement on the matter. [33418/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1371. Deputy Neale Richmond asked the Minister for Health the measures in place and being considered to ensure that arthritis sufferers can access rheumatology services such as physiotherapy, occupational therapy, appointments and treatments during level 5 restrictions and beyond; and if he will make a statement on the matter. [33427/20]
View answerAs this is a service matter, I have asked the HSE to examine the issues raised and to respond to the Deputy as soon as possible.
1373. Deputy Niamh Smyth asked the Minister for Health if funding will be allocated to the relevant Department as part of budget 2021 to support those receiving home help and other vital services in the home during Covid-19; and if he will make a statement on the matter. [26404/20]
View answerBudget 2021 provides for the continuation of the extraordinary public health measures and health and social care service supports introduced in 2020, measures that are essential to protect health care workers, vulnerable groups and the wider public from the worst impacts of COVID-19.
A home first approach is being taken founded on a community model of care that puts in place end to end care pathways to deliver care to people at or near home. This will include an integrated mix of services delivered through Community Health Networks working closely with integrated older person teams, frailty teams, utilisation of new rehabilitation beds and enhanced home care with an additional 5 million hours for 2021. An additional €150 million is being provided for home support in 2021. A new National Home Support Office will be established along with commencing the roll out of interRAI, a comprehensive standard care assessment tool. The intermediate care beds are intended to enable people to avoid going into acute hospitals or when admitted to acute hospitals to enable them to go home more quickly following a period of rehabilitation. These repurposed and additional beds will be located within the 9 Community Healthcare Organisations.
Additional funding allocated to older persons in Budget 2021 will be dedicated to enhancing dementia focussed services and supports. The investment in dementia will increase access to in-home day care, further develop the Dementia: Understand Together initiative, provide 11 more dementia advisers, improve the national network of memory technology resource rooms, deliver an acute hospital dementia and delirium care pathway, and implement the national clinical guideline on the appropriate use of psychotropic medication in people with dementia.
Family carers provide selfless and dedicated care to their loved ones, and the Government recognises that the caring role can be challenging, particularly in current circumstances. Our family carers deserve support to enable them to continue caring with confidence. €2 million has been allocated to provide a more standard package of supports to family carers in every region, known as the “Carer’s Guarantee”. The specific measures to be introduced in the package for family carers will be determined through service level agreements between the HSE and relevant service providers.
1374. Deputy Niamh Smyth asked the Minister for Health the status of a review being conducted into a unit (details supplied); and if he will make a statement on the matter. [30675/20]
View answerAs the Deputy is aware, following reports of a planned merger of the midwifery led unit and consultant led services at Cavan General Hospital, the previous Minister requested that a review be undertaken.
My Department has recently been advised by the HSE's Chief Clinical Officer that the RCSI Hospital Group has undertaken an initial assessment of the Cavan midwifery led unit. The findings of that assessment indicate that if the service is to continue, and indeed expand, the input and support of a senior, external clinician will be required. I understand that a clinician has been identified from within the existing Rotunda Hospital consultant complement, and will commence working and attending at Cavan General Hospital for an average of two days per week in the coming months.
In the meantime, I have been assured that the midwifery led service will continue as before.
1375. Deputy Brian Stanley asked the Minister for Health the progress which has been made to fully reopen services such as speech and language, occupational physiotherapy and child psychology services. [30621/20]
View answer1376. Deputy Brian Stanley asked the Minister for Health if measures will be put in place to clear the backlog of those children that are waiting for speech and language, occupational therapy and child psychology services. [30622/20]
View answerI propose to take Questions Nos. 1375 and 1376 together.
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.
1377. Deputy Pa Daly asked the Minister for Health the criteria applied by the HSE for testing in cases in which a person is a close contact but does not have the Covid-19 app installed. [31560/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1378. Deputy Pa Daly asked the Minister for Health the number of new staff numbers on track and tracing and swabbing duties for 2020 and 2021, including details of those employed directly with the HSE and those employed by third party organisations; and the number of these workers who are full-time versus contract workers. [31561/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1379. Deputy Richard Boyd Barrett asked the Minister for Health his plans to deal with the recent announcement by St. John of God Community Services that it will be withdrawing from the provision of disability services over the next 12 months; and if he will make a statement on the matter. [31342/20]
View answerThe primary concern of the Minister for Health is to ensure the continuity of supports and services for people with disabilities and their families.
As the Deputy will be aware, specialist disability services are provided by a range of organisations. In some cases the HSE itself delivers these services directly and in other circumstances, the HSE relies upon funded providers to deliver these services.
Organisations such as St John of God Community Services provide services for people with a disability on behalf of the HSE, on a contract for services basis, underpinned by Section 38 of the Health Act 2004. Service Level Agreements are set out between the HSE and the individual organisations.
As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1380. Deputy Sean Sherlock asked the Minister for Health the status of an appointment for a person (details supplied). [33431/20]
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.
1381. Deputy Michael McNamara asked the Minister for Health if he is satisfied at the modelling carried out by NPHET in circumstances in which it is predicted in its letter of 15 October 2020, recommending a move to level 5, that 1,800 to 2,500 detected cases per day would be notified by 31 October 2020, there has been a downward trend in detected cases since then and members of NPHET consistently point to a time lag between measures taken to prevent the spread and its impact on detected cases. [33436/20]
View answerThe modelling work carried out by the modelling sub-group (IEMAG) of NPHET supports risk assessment and public health recommendations. Statistical and modelling approaches have significant and important limitations and these limitations are well understood by NPHET and key decision makers. The models used by IEMAG provided possible scenarios showing what might happen if the trends at the time continued. These scenarios are not forecasts or predictions, but instead offer a variety of “what-if” scenarios, showing the rate of infection if reproduction number has a particular value due to underlying population behaviour.
At the time the letter of 15 October was written, R was estimated at 1.4 and cases were growing at 5-6% per day, giving a doubling time of 12-14 days. The growth rate and doubling time for hospitalisation and ICU occupancy were also similar (growth rate 3-4%,doubling time 17-22 days). The letter explicitly stated that the modelling did not take into account the likely impact of Level 3 measures. It is likely that if Level 3 measures had not been implemented across the State, the case numbers indicated in the modelling would have been reached and (ii) visits between households had not been banned, nor Level 4 measures applied to Border Counties, case numbers now would be intermediate between 1,200 per day and the 1,800 projected if the reproduction number had remained at 1.4.
The IEMAG modelling also showed that for each sustained reduction in daily case numbers of 100 per day (say from 1000 cases per day to 900 cases per day) IEMAG predict that over the subsequent month alone this would prevent at least 100-140 hospitalisations, 15-20 admissions to ICU and 10-20 deaths. If case numbers are reduced from 1200 per day to 200 per day, over the subsequent month this will prevent at least 1000-1400 hospitalisations, 150-200 admissions to ICU and 100-200 deaths.
Technical notes on the approaches used by IEMAG are published on the Department of Health website (https://www.gov.ie/en/publication/dc5711-irish-epidemiology-modelling-advisory-group-to-nphet-technical-notes/ ). These are in line with best practice and associated references are available in the published technical notes.
1382. Deputy Michael McNamara asked the Minister for Health if he is satisfied that SI 448 of 2020, in particular regulation 5(2)(r) thereof, is compatible with the EU treaties and a European Council recommendation on a co-ordinated approach to the restriction of free movement in response to the Covid-19 pandemic; and if he will make a statement on the matter. [33437/20]
View answerThe restrictions imposed on movement and events are consistent with legal advice for a proportionate response to an unprecedented situation. The public health measures asking people to stay at home, and the regulations in this area, were aimed at breaking the chain of infection in the community. The section of the SI 448 of 2020 the question refers to, relates to a reasonable excuse to leave one’s home/residence to leave Ireland if you aren’t ordinarily resident in Ireland.
1383. Deputy Claire Kerrane asked the Minister for Health if a closed Covid testing centre (details supplied) could be reopened given the increase in Covid cases and given the fact that it leaves some persons travelling over 60 km to a testing centre; and if he will make a statement on the matter. [33444/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1385. Deputy Jackie Cahill asked the Minister for Health if funding will be made available for a facility owned by an organisation (details supplied) that provides a range of necessary community-based services to allow for necessary works to be carried out in order to make the facility fully operational; and if he will make a statement on the matter. [33486/20]
View answerThe 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.
