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Tuesday, 17 Nov 2020

Written Answers Nos. 703-722

Health Services

Questions (703)

Carol Nolan

Question:

703. Deputy Carol Nolan asked the Minister for Health if private chartered physiotherapy and foot health clinics can provide services during the current level 5 Covid-19 restrictions; and if he will make a statement on the matter. [36234/20]

View answer

Written answers

As the Deputy is aware, 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 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. 

At Level 5 of the Plan, only essential retail outlets and essential services are allowed to open to the public. 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).

In relation to the Deputy's question, there are seventeen professions - including physiotherapists - designated under the 2005 Act, which are encompassed in the list of essential services and 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.

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/

Dental Services

Questions (704)

Michael McNamara

Question:

704. Deputy Michael McNamara asked the Minister for Health the number of dental surgeries carried out; the number of dental surgeries cancelled; the current dental surgery waiting list at Ennis General Hospital from the period March to October 2020; and if he will make a statement on the matter. [36239/20]

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 (705)

John McGuinness

Question:

705. Deputy John McGuinness asked the Minister for Health if an early appointment will be arranged at Cappagh hospital for a person (details supplied). [36251/20]

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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.

Maternity Services

Questions (706, 707, 708, 709)

Colm Burke

Question:

706. Deputy Colm Burke asked the Minister for Health if his Department has explored the role which telemedicine and ehealth solutions can have in providing support to young mothers which would help increase breastfeeding rates in Ireland; and if he will make a statement on the matter. [36255/20]

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Colm Burke

Question:

707. Deputy Colm Burke asked the Minister for Health if his Department has examined recent studies which identify that there are significant advantages for babies if they are breastfed; his plans to initiate a campaign which would promote same; and if he will make a statement on the matter. [36256/20]

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Colm Burke

Question:

708. Deputy Colm Burke asked the Minister for Health if he, Ministers of State within his Department or other officials in his Department have met with third-party groups on promoting breastfeeding in Ireland; if so, the persons or bodies in this regard; and if he will make a statement on the matter. [36257/20]

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Colm Burke

Question:

709. Deputy Colm Burke asked the Minister for Health if there are internal working groups, committees or other relevant bodies in his Department examining the issue of low breastfeeding rates in Ireland; and if he will make a statement on the matter. [36258/20]

View answer

Written answers

I propose to take Questions Nos. 706 to 709, inclusive, together.

Breastfeeding is important for the health of both mother and infant, and national health policy, including the Healthy Ireland Framework, the National Maternity Strategy 2016-2026, the National Obesity Policy and Action Plan 2016-2025 and the National Cancer Strategy 2017-2026, emphasise the importance of supporting mothers who breastfeed, as well as taking action to increase breastfeeding rates in Ireland.

Encouraging mothers to breastfeed is a priority for the Department of Health.  To deliver on this priority, the HSE is working to achieve the aims and objectives of the Breastfeeding in a Healthy Ireland – HSE Action Plan 2016-2021. The National Breastfeeding Coordinators team in the HSE have regular links with the Health Promotion Advisor in Health and Wellbeing in the Department.

Implementation of the Breastfeeding in a Healthy Ireland – HSE Action Plan 2016-2021 includes initiatives in the following areas:

1. Improved governance and health service structures

2. Breastfeeding training and skills development

3. Health service policies and practices

4. Support at all stages of the breastfeeding continuum through social marketing, support and advocacy.

The HSE is partnering with key stakeholders to develop the supports that mothers require at all stages of the breastfeeding continuum through social marketing, support and advocacy. The www.mychild.ie website provides pregnant and new mothers and families with a range of information and supports about infant feeding. An Ask Our Expert (AOE) on-line service, provided by International Board-Certified Lactation Consultants, is available to answer mothers' questions and link them to supports in their local area. The webchat facility and HSE breastfeeding Facebook page is also available. These services provide supportive and practical expert information in a friendly, supportive and non-judgemental manner.

The Maternity Strategy states that "in addition to practical supports which can be provided to mothers, such as support to continue breastfeeding on return to the workplace, a broader societal change in required in order to promote a more positive culture around breastfeeding. This should support women to feel confident about their choice to breastfeed". In essence, this means that all mothers should be supported to breastfeed at anytime and anywhere.

The National Strategy for Women and Girls 2017-2020 re-affirmed the commitment to advance public support of breastfeeding and includes an action to extend provision for breastfeeding breaks under employment legislation (currently available to mothers of children under 6 months).

The HSE’s National Women and Infants Health Programme, in collaboration with health promotion and improvement and public health services in the HSE, supports the implementation of the WHO/UNICEF 10 Steps to Successful Breastfeeding using a model suitable for the promotion and support of breastfeeding in Ireland. This approach is also examining the option of an all-island approach.

I can assure the Deputy that that breastfeeding will remain a priority and the Department of Health and the HSE will continue working to achieve the aims and objectives of the Breastfeeding in a Healthy Ireland – HSE Action Plan 2016-2021.

Maternity Services

Questions (710)

Colm Burke

Question:

710. Deputy Colm Burke asked the Minister for Health the number of certified lactation consultants working in the 19 maternity units across the country; the number in each unit in tabular form; and if he will make a statement on the matter. [36259/20]

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.

General Practitioner Services

Questions (711)

Paul McAuliffe

Question:

711. Deputy Paul McAuliffe asked the Minister for Health if his attention has been drawn to the fact that general practitioners in Finglas, Dublin 11, are not accepting new medical card patients; and if he will make a statement on the matter. [36260/20]

View answer

Written answers

Where a GMS patient experiences difficulty in finding a GP to accept him/her as a patient, the person concerned having unsuccessfully applied to at least three GPs in the area can apply to the HSE which has the power to assign that person to a GP's GMS patient list.

People who do not hold a medical card or GP visit card access GP services on a private basis and can make enquiries directly to any GP practice they wish to register with. As private contractors, it is a matter for each individual GP to decide whether to accept additional private patients.

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 to improve recruitment and retention in general practice.

The 2019 Agreement on GP contractual reforms will see the Government increase investment in general practice by approximately 40% (€210 million) between 2019 and 2023, 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.

The number of GPs entering training has been increased steadily over the past ten years, rising from 120 in 2009 to 214 in 2020, with a further increase foreseen in 2021.

These measures will see an increase in the number of GPs working in the State, improving access to GP services for patients throughout the country.

Vaccination Programme

Questions (712, 730, 750, 753, 839)

Paul McAuliffe

Question:

712. Deputy Paul McAuliffe asked the Minister for Health if there is a national shortage of the flu vaccine for adults; and if he will make a statement on the matter. [36261/20]

View answer

Pádraig O'Sullivan

Question:

730. Deputy Pádraig O'Sullivan asked the Minister for Health the status of the winter flu vaccination programme; when it is due to be completed; and if he will make a statement on the matter. [36324/20]

View answer

Denise Mitchell

Question:

750. Deputy Denise Mitchell asked the Minister for Health when the flu vaccine will be widely available again; the steps being taken to secure vaccines to address the current shortage; his plans to prioritise those most at risk with access to vaccines; and if he will make a statement on the matter. [36462/20]

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Cian O'Callaghan

Question:

753. Deputy Cian O'Callaghan asked the Minister for Health if his attention has been drawn to the shortages of availability of the 2020 flu vaccine; the number on waiting lists for the vaccine; the length of time until there will be adequate supply to vaccinate all those seeking vaccination; and if he will make a statement on the matter. [36487/20]

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Éamon Ó Cuív

Question:

839. Deputy Éamon Ó Cuív asked the Minister for Health the steps he has taken to ensure that adequate supplies of flu vaccine are available to all general practitioners to cover all target groups - the old, the pregnant and the disabled - and other vulnerable persons with serious underlying conditions; and if he will make a statement on the matter. [36989/20]

View answer

Written answers

I propose to take Questions Nos. 712, 730, 750, 753 and 839 together.

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

This season, 1.95 million doses of influenza vaccine have been purchased, which is double the amount administered last season. The HSE has procured 1.35 million doses of the Quadrivalent Influenza Vaccine (QIV) for the forthcoming winter. This vaccine is being made available to all persons in an at-risk group and aged from 6 months up. In addition, the HSE has also purchased 600,000 doses of the Live Attenuated Influenza Vaccine (LAIV), which is delivered via nasal drops rather than by injection and is being made available to all children aged from 2 to 12 years old inclusive.

Deliveries of this vaccine from the manufacturer were not as quick as we would have liked, due to the very challenging international market for flu vaccines. It is also true that demand for vaccination this year is unprecedented. This is the case across Europe and beyond, and in this context it is unlikely that additional supply will become available.

I can confirm that 1.3 million of the 1.35 million doses of flu vaccine available this winter have been distributed to GPs, pharmacists and other vaccination sites since early October. In addition, 420,000 doses of the LAIV for administration to children aged from 2 to 12 have been distributed.

Demand for vaccination remains strong at this point and may exceed available supply. It is likely that the full amount procured, 1.35 million doses, will be distributed and administered. As a consequence, from the fourth round of deliveries which started on 23 October, GPs and pharmacists have been asked that of remaining patients in at-risk groups, priority should be given to the over-65s and healthcare workers with direct patient contact, in line with WHO advice.

Each year a certain amount of vaccine is “held back” to ensure those in at-risk groups receive vaccines. With the unprecedented demand this year it is important that the HSE manage the distribution of the remaining doses in order to target administration to the at-risk groups who need it the most. The distribution of the final 50,000 doses will commence by the end of this month. The significant increase in uptake among those in the at-risk groups, combined with the addition of vaccination for children aged from 2 to 12, will help reduce the impact of influenza on the community and the health system.

Vaccinations are ordered well in advance – the HSE placed its order for the vaccine for those in at-risk groups in February. The HSE order for the 2020/21 season was 20% greater than the order for the 2019/20 season and about 35% more than 2019/20 uptake. These figures do not include the additional 600,000 doses of vaccine ordered for children aged from 2 – 12, which would bring to almost 75% the additional number of doses of vaccine available this year. Given the demand on the international market for influenza vaccine, it is not realistically possible to procure more vaccine at this point.

When the vaccination programme is complete, we will have vaccinated more people in at-risk groups than ever before. Current trends suggest that at least 350,000 more individuals in the at-risk groups will receive the flu vaccine this winter than last, including those over 65 and healthcare workers. In addition, over 100,000 children have already received the vaccination which is being provided without charge this year for the first time. I expect this number to increase significantly in the coming weeks also.

Covid-19 Pandemic

Questions (713)

Paul McAuliffe

Question:

713. Deputy Paul McAuliffe asked the Minister for Health when the results of the SCOPI: COVID-19 antibody research study will be finalised and published; and if he will make a statement on the matter. [36262/20]

View answer

Written answers

The report of the Study to Investigate COVID-19 Infection in People Living in Ireland (SCOPI): A national seroprevalence study, June-July 2020 was published on 21 August 2020 and is available at:

https://www.hse.ie/eng/services/news/newsfeatures/scopi-covid-19-antibody-research-study-results/

Nursing Staff

Questions (714)

Neale Richmond

Question:

714. Deputy Neale Richmond asked the Minister for Health the status of the plan to have all student nurses remunerated for their work on the front lines; and if he will make a statement on the matter. [36264/20]

View answer

Written answers

The HSE continues to fund the employment of fourth year student nurses and midwives who are on rostered work placements in hospital settings, including those scheduled to commence in the coming weeks and those fourth year students who are to commence rostered work placement in 2021.

These fourth student nurses and midwives on rostered work placement are paid at the approved rate as detailed on the HSE salary scale of €22,229 (annualised - psychiatric nursing specialism) and €21,749 (annualised - all other nursing specialisms).

In addition there are other supports open to all eligible nursing students:

An accommodation allowance available for eligible nursing students which amounts up to €50.79 a week for the duration of the placement where it is necessary for the student to obtain accommodation away from his/her normal place of residence.

A travel allowance is also available to eligible nursing students.

My Department is currently reviewing these allowances for this year’s student nurses on clinical placements, taking into account the impact of COVID-19 pandemic on such placements and expects to conclude this review shortly.

Maternity Services

Questions (715)

Aengus Ó Snodaigh

Question:

715. Deputy Aengus Ó Snodaigh asked the Minister for Health the average waiting time for gynaecological services for a woman in need of an ultrasound scan in St. James’s Hospital, the Coombe Women and Infants University Hospital and Tallaght Hospital. [36265/20]

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.

Maternity Services

Questions (716)

Aengus Ó Snodaigh

Question:

716. Deputy Aengus Ó Snodaigh asked the Minister for Health if his attention has been drawn to the case of a person (details supplied). [36266/20]

View answer

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 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.

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 two initiatives for Outpatient appointments for the Coombe Hospital have been approved in 2020. These initiatives will facilitate treatment for 1,250 patients on the Outpatient waiting list. 

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

Commencement of Legislation

Questions (717)

Charles Flanagan

Question:

717. Deputy Charles Flanagan asked the Minister for Health the preparations undertaken to date for the commencement of Part 8 of the Assisted Decision-Making (Capacity) Act 2015 in view of recommendations 10.2 to 10.4 of the report of the Covid-19 nursing homes expert panel; if there is a need for an amendment to this Part of the Act; the progress on the writing of regulations to allow for a register of advance healthcare directives; the indicative timeline for commencement; and if he will make a statement on the matter. [36267/20]

View answer

Written answers

Part 8 of the Assisted Decision Making (Capacity) Act 2015 provides a legislative framework for Advanced Healthcare Directives (AHDs).  An AHD is a statement made by a person with capacity setting out his or her will and preferences regarding treatment decisions that may arise in the future when he or she no longer has capacity.

My Department remains committed to commencing these provisions as soon as possible.  The development of a code of practice to accompany the AHD provisions is a key piece of work to facilitate commencement.  The AHD multidisciplinary working group established by the Minister in 2016 has developed a code of practice for Part 8 and submitted it to the Director of Decision Support Services in December 2018 for consideration.  When this has been finalised by the Director it will be submitted to me for approval prior to publication.  

Establishment of a AHD Register is a complex undertaking and the Department intends to explore options relating to the implementation of an AHD Register and the associated Regulations. However, while Part 8 of the  2015 Act allows for regulations for a register of advance healthcare directives it does not require this register to be established before the Act is commenced.

There are a number of other interdependencies which must be addressed before Part 8 can be commenced and work is continuing in respect of all outstanding matters. These also include commencing certain other provisions of the Act outside of Part 8 that fall under the remit of the Department of Children, Equality, Disability, Integration and Youth. Justice and Equality.

Covid-19 Pandemic

Questions (718)

Michael McNamara

Question:

718. Deputy Michael McNamara asked the Minister for Health if vitamin D3 and-or zinc supplementation has an effect on reducing respiratory infection and Covid-19; if so, his views on whether it is appropriate to include same in NPHET public health advisories and HSE information campaigns; and if he will make a statement on the matter. [36270/20]

View answer

Written answers

I can assure the Deputy that the public health advice relating to Covid-19 is kept under continuing review by the NPHET.  Ireland is guided by the advice, guidance and protocols of the World Health Organization (WHO) and the Centres for Disease Control and Prevention (CDC). The expert guidance of the  European Centre for Disease Prevention and Control (ECDC) in particular is based upon consideration of the circumstances arising in the European Union and globally. The National Public Health Emergency Team (NPHET) reviews these international developments as part of its overall examination of the evolving epidemiology of the disease.  

Micronutrients, such as vitamins D and C and zinc, are critical for a well-functioning immune system and play a vital role in promoting health and nutritional well-being.  However, the consistent guidance from the international bodies referenced above is that there is as yet insufficient data to support the use of either Vitamin D or zinc in the prevention or treatment of COVID-19.

Maternity Services

Questions (719)

Bríd Smith

Question:

719. Deputy Bríd Smith asked the Minister for Health the reason the HSE has authorised a temporary cessation of waterbirth effectively limiting the options and choices of mothers further given the current Covid-19 restrictions with regard to partners attending maternity visits; the reason an association (details supplied) as providers of the service were not included in discussions prior to the decision to cease the waterbirth service; if the service will resume as soon as possible; and if he will make a statement on the matter. [36273/20]

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.

Charities Regulation

Questions (720, 721, 722)

Violet-Anne Wynne

Question:

720. Deputy Violet-Anne Wynne asked the Minister for Health if his attention has been drawn to an issue within an organisation (details supplied) that is heavily funded by the HSE; and if he will make a statement on the matter. [36277/20]

View answer

Violet-Anne Wynne

Question:

721. Deputy Violet-Anne Wynne asked the Minister for Health if he will examine the operations of an organisation (details supplied) further to questions about the organisation structures of same, taking into account that the organisation is heavily funded by the HSE. [36278/20]

View answer

Violet-Anne Wynne

Question:

722. Deputy Violet-Anne Wynne asked the Minister for Health if his attention has been drawn to the fact that a number of letters of complaint were sent to the Charities Regulator about an organisation (details supplied) which is heavily funded by the HSE; and if he will make a statement on the matter. [36279/20]

View answer

Written answers

I propose to take Questions Nos. 720 to 722, inclusive, together.

The HSE provide funding to the Irish Men’s Sheds Association (IMSA) for their core running costs as well as their Sheds for Life health and wellbeing programme.

This funding is the subject of a Grant Aid Agreement with the IMSA.

I am aware that a number of anonymous complaints had been reported by the IMSA to the HSE. The IMSA has also advised the HSE of a campaign of online harassment directed at their organisation, and that a further complaint has subsequently been made to the Charities Regulator.

However, I am advised by the HSE that they have no governance concerns around the administration of the Association and I have asked the Executive to keep me informed of any further developments in this matter.

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