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Thursday, 12 Nov 2020

Written Answers Nos. 336-354

National Drugs Strategy

Questions (336)

Niall Collins

Question:

336. Deputy Niall Collins asked the Minister for Health the details of the €10 million in funding announced in budget 2021 for the national drugs strategy; if the drugs and alcohol task force in Tallaght, Dublin 24, is included in funding for the expanded family support services; and if he will make a statement on the matter. [35948/20]

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Written answers

Budget 2021 allocated €10m in new developments for drugs policy and inclusion health.

Of this, €4m was allocated to provide for the implementation of the national drugs strategy 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 was allocated to address the addiction and mental health needs of people who are homeless as follows:

- €1m to provide health supports for 218 new tenancies under the Housing First programme.

- €1.55m to develop and deliver a customised health care plan for 1,300 single people living in emergency accommodation

- €1.4m to provide additional services for people who are homeless with complex health needs, including those with chronic mental health issues and those leaving hospitals or other treatment services.

A further €2m was allocated to enhance access to health services for other socially excluded groups, as follows:

- €870,000 to improve access to healthcare services for the Roma community and other vulnerable migrants across all CHOs

- €€270,000 to expand Traveller health units, as a first phase of the forthcoming HSE Traveller health action plan

- €750,000 to enhance healthcare services for the c 8,000 asylum seekers and refugees living in direct provision

- €175,000 for initiatives for victims of domestic violence and the LGBTI+ community.

Further details of the measures will be set out the HSE national service plan for 2021.

I would advise Tallaght Drug and Alcohol Task Force to contact their community healthcare organisation to enquire about the allocation of new funding to their locality.

Cancer Services

Questions (337)

Fergus O'Dowd

Question:

337. Deputy Fergus O'Dowd asked the Minister for Health his views on a document (details supplied) regarding cancer services; if the document will be assessed; his objectives in respect of further progressing an all-island strategy on the matter; and if he will make a statement on the matter. [35950/20]

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Written answers

I welcome the document to which the Deputy refers, and which has been submitted to my Department, in relation to an All-Island Cancer Research proposal. The issues involved will be considered and I would envisage a meeting being organised between the Working Group involved and officials of the Department.

The positive impact of research activity on the care of patients is recognised in the National Cancer Strategy 2017-2026. Also, North-South collaboration is also a key component of the delivery of cancer services in Ireland, including the provision of radiotherapy treatment to Donegal patients in the North West Cancer Centre, Altnagelvin, Derry.

HSE Staff

Questions (338)

Neale Richmond

Question:

338. Deputy Neale Richmond asked the Minister for Health the additional supports that will be provided to specialists in public health medicine to bring their contracts in line with their duties and responsibilities; and if he will make a statement on the matter. [35954/20]

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Written answers

I, my Department and the HSE are committed to the early introduction of a new framework for public healthcare, as provided for in the Programme for Government, and to the framework incorporating consultant status. Consultant status for the Specialty was recommended in the Crowe Horwath Report in the context of a new framework for public health and enhanced roles for the specialists. It is also consistent with the role envisaged for the Specialists in Slaintecare and Professor Scally’s Report on the National Screening Service ('CervicalCheck') under a new public health framework.

It is recognised that the pandemic has accelerated the implementation of many of the Crowe Horwath recommendations in relation to the roles of the Specialists and that this will continue under the immediate Pandemic Framework.

My Department and the HSE are working intensively to finalise this framework, having regard also to the immediate model required in response to the pandemic. We are committed to progressing this and engaging with the Department of Public Expenditure on the matter as soon as possible.

General Practitioner Services

Questions (339)

Matt Carthy

Question:

339. Deputy Matt Carthy asked the Minister for Health his plans to address the general practitioner shortage in the area of Carrickmacross, County Monaghan; and if he will make a statement on the matter. [35975/20]

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Written answers

The Government is aware of the workforce issues currently facing general practice, including the limited access to GP services in certain areas, and has implemented a number of measures in recent years to improve recruitment and retention in general practice.

Changes have been made to the entry provisions to the GMS scheme to accommodate more flexible/shared GMS GP contracts, and to the retirement provisions for GPs under the GMS scheme, allowing GPs to hold GMS contracts until their 72nd birthday.

The 2019 Agreement on GP contractual reforms will see the Government increase investment in general practice by approximately 40% (€210 million) over the next four years, providing for significant increases in capitation fees for GPs who participate in the reform programme and the introduction of new fees and subsidies for additional services such as the chronic disease programme. There will be increased support for GPs working in rural practices and for those in disadvantaged urban areas, and improvements have been made to maternity and paternity leave arrangements.

In addition, the number of GPs entering training has been increased steadily over the past ten years, rising from 120 in 2009 to 194 in 2020, with a further increase foreseen in 2021.

These measures will help make general practice a more attractive career option for doctors and will increase the number of doctors in general practice, improving access to GP services for patients throughout the country.

In relation to the availability of GP services in the Carrickmacross area specifically, as this relates to a services matter, I have asked the Health Service Executive to respond to the Deputy directly on this matter, as soon as possible.

Disability Support Services

Questions (340)

Matt Carthy

Question:

340. Deputy Matt Carthy asked the Minister for Health the reason it is planned that the group home for persons with physical and sensory disabilities at Drummond Otra, Carrickmacross, County Monaghan, will be operated by an external service provider rather than staffed with HSE personnel; when the centre will become operational; and if he will make a statement on the matter. [35976/20]

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Written answers

The 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.

Covid-19 Pandemic

Questions (341)

Matt Carthy

Question:

341. Deputy Matt Carthy asked the Minister for Health if his Department or an agency operating under his Department has encountered expenditure in respect of hand sanitisation products or other PPE products that were subsequently subject to a recall by the Department of Agriculture, Food and the Marine in 2020; if so, the expenditure in respect of such products; if the expenditures will be recouped from the sellers; and if he will make a statement on the matter. [36006/20]

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Written answers

No products stocked or used by my Department were affected by the specified recall.

I have also forwarded your question to the HSE for direct reply. Details for other bodies under the aegis of my Department are operational matters for the bodies concerned.

Covid-19 Pandemic

Questions (342)

Paul Murphy

Question:

342. Deputy Paul Murphy asked the Minister for Health if the HSE has put a standard PPE procedure in place for the hospital staff, including student nurses and midwives, who are involved in the treatment of Covid-19-infected patients in hospitals; if the HSE has put a standard cohorting procedure in place for Covid-19-infected patients in hospitals to prevent the spread of infection; if all hospital staff, including student nurses and midwives, are regularly made aware of these procedures; if there is a confidential reporting procedure in place by which staff, including student nurses and midwives, can report concerns about the implementation of such Covid-19-related procedures (details supplied); and if he will make a statement on the matter. [36015/20]

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Written answers

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

Nursing Staff

Questions (343)

Paul Murphy

Question:

343. Deputy Paul Murphy asked the Minister for Health if he will reinstate the healthcare assistant pay scheme for student nurses and midwives which was introduced in March 2020 but is no longer in operation; and if he will make a statement on the matter. [36016/20]

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Written answers

The Health Care Assistant initiative, whereby student nurses and midwives were offered temporary contracts as HCAs, was in response to the Covid19 outbreak and ceased in August 2020. This initiative was only ever intended as a temporary measure to provide additional support to the national effort. It also offered some protection to the ongoing education of student nurses and midwives as their clinical placements at the time had ceased.

Clinical placements for Student Nurses have resumed. There are no plans at present to reinstate this initiative.

Protected Disclosures

Questions (344)

Bríd Smith

Question:

344. Deputy Bríd Smith asked the Minister for Health if a protected disclosure has been received from staff in a hospice (details supplied); the actions he plans to take on the disclosure; if this disclosure is the same as a previous disclosure sent to his predecessor in 2018; the actions that were taken by the HSE on same; and if he will make a statement on the matter. [36025/20]

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Written answers

My Department is aware of the correspondence referred to by the Deputy and is examining the matter.

It is my Department's policy not to comment on individual cases, to ensure the confidentiality of the discloser is maintained.

Vaccination Programme

Questions (345)

Johnny Mythen

Question:

345. Deputy Johnny Mythen asked the Minister for Health if he will immediately review the HSE distribution chain for the winter flu vaccine (details supplied) [36030/20]

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Written answers

The Government has expanded the provision of seasonal influenza vaccination without charge to all of those in the HSE-defined at-risk groups and to all children aged from 2 to 12 years. Vaccines are being administered via GPs and pharmacists, as in previous years.

This season, approximately 2 million doses of influenza vaccine have been purchased, including 1.35 million doses of QIV vaccine for adults, and 600,000 of nasal LAIV for children aged 2-12 years. The amount procured for this year is almost double the amount administered last season in Ireland. Deliveries of this vaccine from the manufacturer have not been as quick as we would have liked, due to the very challenging international market for flu vaccines.

The fourth round of vaccine distribution to GPs and pharmacists which was completed on 11 November will bring to 1.3 million the total number of injected doses distributed. The remaining doses of vaccine will be distributed to GPs and pharmacists in the coming weeks. Given the difficult international market for flu vaccines this year, it is unlikely that any further increase in supply will be possible.

Retail Pharmacists have been administrating influenza vaccine as part on the National programme since influenza season 2012/2013. However, this is the first season that the nasal (LAIV) influenza vaccine programme for children aged 2-12 years is available.

The number of doses available for pharmacists was based on their usage of adult flu vaccine as an indication for their first delivery of LAIV. Pharmacists were automatically allowed to order the same amount for subsequent deliveries every fortnight, but were allowed to request an increase in the amount for every subsequent delivery if they had demand for the vaccine. To date 75% of 600,000 doses purchased by HSE have been delivered to sites.

Demand for the flu vaccine this year is unprecedented. Given the finite supply available, it is important that even the increased quantities available in Ireland are targeted where they will have the greatest impact. Distribution of the remaining doses will be controlled by the HSE to target administration to those at-risk groups where it is most needed.

Drug Treatment Programmes

Questions (346)

Gary Gannon

Question:

346. Deputy Gary Gannon asked the Minister for Health the date for the reopening of the Keltoi residential drugs and alcohol service, Phoenix Park, Dublin 20, which was closed in March 2020; and if he will make a statement on the matter. [36038/20]

View answer

Written answers

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 (347)

Pearse Doherty

Question:

347. Deputy Pearse Doherty asked the Minister for Health when a person (details supplied) will have an operation at Beaumont Hospital; and if he will make a statement on the matter. [36042/20]

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Written answers

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 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.

Speech and Language Therapy

Questions (348)

Pearse Doherty

Question:

348. Deputy Pearse Doherty asked the Minister for Health when it is planned to resume speech and language services in County Donegal with speech and language therapists returning to their positions; and if he will make a statement on the matter. [36043/20]

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Written answers

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 question relates to a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.

Speech and Language Therapy

Questions (349)

Pearse Doherty

Question:

349. Deputy Pearse Doherty asked the Minister for Health the number of speech and language therapists redeployed to Covid-19 testing in County Donegal per month to date in 2020; the number of those who resumed their roles in tabular form; and if he will make a statement on the matter. [36044/20]

View answer

Written answers

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

Speech and Language Therapy

Questions (350)

Pearse Doherty

Question:

350. Deputy Pearse Doherty asked the Minister for Health his plans to recruit Covid-19 testers in County Donegal to allow speech and language therapists to resume their positions in their qualified field; when it may be expected this will occur; and if he will make a statement on the matter. [36045/20]

View answer

Written answers

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 Pandemic

Questions (351)

John Brady

Question:

351. Deputy John Brady asked the Minister for Health if day care facilities and grooming salons for pets are deemed an essential service under the term "animal welfare" as per the Health Act 1947 (Section 31A - Temporary Restrictions) (Covid-19) (No. 8) Regulations 2020; and if he will make a statement on the matter. [36046/20]

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Written answers

It is important to note that the Government is committed to ensuring a balanced and proportionate response to COVID-19 by finding ways to implement public health measures in response to the pandemic in a way that is fair, reasonable and proportionate.

As you will be aware, in response to the rapidly deteriorating epidemiological situation across the country, Ireland has moved to level 5 of the Government’s medium-term strategy for dealing with COVID-19, Resilience and Recovery 2020-2021: Plan for Living with COVID-19.

This 5 level Framework reflects a careful consideration of the impact of the introduction of restrictions on employment and livelihoods, keeping as many businesses open as possible at different stages, while acknowledging that some businesses and services are critical.

Any measures introduced at any level of the Plan are aimed at limiting the spread and damage of COVID-19, and are necessary to protect our key priorities of supporting and maintaining health and social care services, keeping education and childcare services open and protecting the most vulnerable members of our communities.

As I'm sure you can appreciate, COVID-19 spreads when individuals and groups come into close contact with one another, enabling the virus to move from one person to another. COVID-19 is infectious in a person with no symptoms, or for the period of time before they develop symptoms. The number of people allowed to gather in different scenarios in the Government's Framework are based on a review of international practice and the judgment of public health experts. It seeks to balance the risks of different types of gatherings against the desire to allow normal activities to proceed in so far as possible.

At level 5 of the Plan, unfortunately, this means closing many businesses and amenities to reduce the person-to-person contacts which allow the virus to spread. At Level 5 only essential retail and essential services will remain open. This list does not include dog grooming or dog training services or facilities but does include the provision of veterinary, animal welfare and related services. It is appreciated that these measures are difficult, but they have been put in place to protect public health.

Further information on essential retail and essential services at Level 5 can be found at: htt ps://www.gov.ie/en/publication/c9158-essential-services/ and information on the public health measures in place at all the levels at: https://www.gov.ie/en/campaigns/resilience-recovery-2020-2021-plan-for-living-with-covid-19/

Oireachtas Joint Committee Reports

Questions (352)

Brendan Smith

Question:

352. Deputy Brendan Smith asked the Minister for Health the progress to date on implementing the recommendations of the 2018 report by the Oireachtas Joint Committee on Health on foetal anti-convulsant syndrome; and if he will make a statement on the matter. [36053/20]

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Written answers

Valproate-containing medicines (also known as sodium valproate or valproic acid) are approved in Ireland under the brand name Epilim, for the treatment of epilepsy and bipolar disorder. Based on the totality of available scientific data on this drug, it is known that children exposed in utero are at a high risk of serious developmental disorders (in up to 30-40% of cases) and congenital malformations (in approximately 10% of cases).

To prevent exposure during pregnancy, there is a robust regulatory framework for the licensed use of Epilim in women of childbearing potential. This regulatory framework was strengthened following participation by the Health Products Regulatory Authority (HPRA) in two EU-wide reviews in 2014 and 2017.

After the European Medicines Agency (EMA) issued new recommendations on the use of sodium valproate in early 2018, the HPRA collaborated with national stakeholders, including patient representatives and healthcare professionals, to implement the new valproate risk-minimisation measures in Ireland. These measures included changes to the product information for patients and healthcare professionals; a visual warning on the packaging of valproate medicines; updated educational materials to reflect the new measures and provide age-appropriate advice; and a patient alert card to be attached to the packaging so that pharmacists can go through it with the patient when valproate is dispensed.

To support the actions taken by the HPRA, the Pharmaceutical Society of Ireland directed pharmacists that they must inform women of child-bearing age of the potential risk of abnormal pregnancy outcomes when supplying any medicine containing valproate. This includes providing counselling and including a Package Leaflet and Alert Card with each supply of these medicines.

To address the more operational aspects of this issue, a HSE Valproate Response Project was established in May 2018 under the remit of the HSE Office of the Chief Clinical Officer. The Project Team was able to provide expert support to individuals and families with concerns about previous exposure to valproate and the possible impact on their children. The HSE team has also worked to improve the structures in place to support families affected by foetal valproate syndrome. A specialist dedicated genetics clinic has been established in Our Lady’s Hospital, Crumlin, to support diagnosis, and the HSE is working to improve access to genetic testing.

The HSE’s medium- to long-term response to the valproate issue is focused on the establishment of a Programme for Women’s Health in Epilepsy within one of the Regional Epilepsy Centres, which will coordinate this national response. This means that all women taking valproate will have yearly follow-up, sign a valproate agreement form, be kept up-to-date with developments and signposted to other services, including the diagnostic service for those potentially exposed during pregnancy.

With regard to the Joint Committee's recommendation regarding the establishment of an independent inquiry into the use of valproate medicines in Ireland, there are no plans to hold such an inquiry at present.

Pre-Hospital Emergency Care Council

Questions (353)

Paul Kehoe

Question:

353. Deputy Paul Kehoe asked the Minister for Health if he will address a matter (details supplied) regarding the recognised institutional member on the Pre-Hospital Emergency Care Council; his plans to appoint an educational nominee from the National Ambulance Service when it comes to personal selections later in 2020; and if he will make a statement on the matter. [36061/20]

View answer

Written answers

As the Deputy may be aware, the composition of the Pre-Hospital Emergency Care Council is determined by article 5 of S.I. 109 of 2000, as amended. All appointments to the Council are made in line with the requirements of this legislation. In June this year, nominations were sought under article 5(c) of the SI, which specifies that two Council members “shall be persons appointed from recognised institutions on the nomination of the heads of those institutions.” Article 4(a) of the S.I. 109 defines these institutions as being those which are those recognised by PHECC as providing relevant education and training.

In accordance with the provisions of S.I. 109 of 2000, and the DPER Guidelines on Appointments to State Boards, individuals who have previously served two terms on the PHECC Council are not eligible for re-appointment.

With reference to the appointment of educational nominees as referred to by the Deputy, I can advise that no further Council vacancies under Section 5(c) are expected in 2020. All vacancies arising in respect of the PHECC Council will be processed in accordance with S.I. 109 of 2000, and the Guidelines on Appointments to State Boards, as applicable.

Covid-19 Pandemic

Questions (354)

Róisín Shortall

Question:

354. Deputy Róisín Shortall asked the Minister for Health if clarification and guidance will be provided on the continuing operation of beauty clinics offering Botox and other injectable treatments (details supplied); and if he will make a statement on the matter. [36078/20]

View answer

Written answers

The Government's medium-term strategy Resilience and Recovery 2020-2021: Plan for Living with COVID-19 sets out Ireland's approach to managing and living with COVID-19 in a range of areas over the next 6 - 9 months.

The Plan sets out five levels of response, each with a number of measures designed to help us all lower COVID-19 transmission and setting out what is permitted at that moment in time. It aims to allow society and businesses to be able to operate as normally as possible, while continuing to suppress the virus. Each level outlines what is permitted for social or family gatherings, work and public transport, bars, hotels and restaurants, exercise activities and religious services.

The Plan reflects a careful consideration of the impact of the introduction of restrictions on employment and livelihoods, keeping as many businesses open as possible at different stages, while acknowledging that some businesses and services are critical.

The Health Act 1947 (Section 31A-Temporary Restrictions) (COVID-19) (No.8) Regulations 2020, which give effect to the level 5 restrictions under the Plan, provide the list of essential retail and essential services which may operate under level 5 restrictions.

The list of essential services that can remain open during Level 5 includes therapy services provided by a member of a designated profession within the meaning of section 3 of the Health and Social Care Professionals Act 2005 (No. 27 of 2005). There are seventeen professions designated under the 2005 Act, which are encompassed in the list of essential services. These are: Dietitians, Dispensing Opticians, Medical Scientists, Occupational Therapists, Optometrists, Physiotherapists (which includes Physical Therapists), Radiographers, Radiation Therapists, Social Workers, Speech and Language Therapists, Clinical Biochemists, Counsellors, Orthoptists, Podiatrists, Psychologists, Psychotherapists and Social Care Workers.

Information on the public health measures in currently in place in relation to the different levels, including essential retail and essential services, can be found at www.gov.ie/en/campaigns/resilience-recovery-2020-2021-plan-for-living-with-covid-19/.

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/

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