James Browne
Question:190. Deputy James Browne asked the Minister for Health the position regarding adult winter 'flu vaccines (details supplied); and if he will make a statement on the matter. [37266/20]
View answerVaccination Programme
Questions (190)
Written answers
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.
While I cannot comment on individual providers, 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. Distribution of the remaining 50,000 doses will commence before the end of this month. 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.
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.
Health Services
Questions (191)
Pádraig O'Sullivan
Question:191. Deputy Pádraig O'Sullivan asked the Minister for Health when a facility (details supplied) will receive sufficient rain shelter; and if he will make a statement on the matter. [37282/20]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
National Maternity Hospital
Questions (192)
Róisín Shortall
Question:192. Deputy Róisín Shortall asked the Minister for Health if the lease of the site for the new National Maternity Hospital has been agreed with a group (details supplied); the status of negotiations on the lease; the duration of the lease; and if he will make a statement on the matter. [37293/20]
View answerWritten answers
The St Vincent’s Healthcare Group will provide the HSE with a 99 year lease for the site of the new maternity hospital at Elm Park. I am advised that while there are a small number of outstanding issues that remain to be resolved, it is hoped that the drafting of the Lease can be concluded shortly.
As the Deputy will be aware, a legal framework is being developed to protect the State’s interest in the new hospital, of which the Lease is one constituent part.
However, as I have indicated previously, once finalised, the legal framework will be brought to Government for approval.
National Maternity Hospital
Questions (193)
Róisín Shortall
Question:193. Deputy Róisín Shortall asked the Minister for Health further to Parliamentary Question No. 1139 of 3 November 2020, if the reply will be reconciled with the fact that the company (details supplied) will not retain the legal right to mortgage the hospital; the steps he will take to ensure that this provision in its constitution does not give it authority to mortgage any or all parts of the hospital; and if he will make a statement on the matter. [37294/20]
View answerWritten answers
St Vincent’s Holdings CLG will not hold a property interest in, all or part of, the new National Maternity Hospital. Under the legal framework currently being developed, St Vincent’s Healthcare Group DAC (SVHG DAC) will lease a site to the State, and the State will provide an Operating Licence to the National Maternity Hospital at Elm Park DAC and SVHG DAC. The ability of SVHG DAC to mortgage, as contained in its Constitution, is being addressed within the legal framework and restrictions, as appropriate, will apply.
National Maternity Hospital
Questions (194)
Róisín Shortall
Question:194. Deputy Róisín Shortall asked the Minister for Health the timeline provided to transfer shares in a group (details supplied) to the HSE by a religious organisation; and if he will make a statement on the matter. [37296/20]
View answerWritten answers
My understanding is that the approval of the HSE is required to facilitate the transfer by the Religious Sisters of Charity of their shareholding in St Vincent’s Healthcare Group (SVHG) to St Vincent’s Holding CLG. I am advised that the SVHG has sought this approval and the parties are currently engaging. However, as the HSE would be best placed to provide the most up-to-date position on this matter, I have asked them to respond to you directly.
Emergency Departments
Questions (195)
Aengus Ó Snodaigh
Question:195. Deputy Aengus Ó Snodaigh asked the Minister for Health the number of admissions to accident and emergency departments as a result of accidents involving delivery vans, trucks, buses, cars, farm vehicles, bicycles, electric scooter, motorbikes; and if those admitted were drivers, passengers or pedestrians; and if he will make a statement on the matter. [37300/20]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
Emergency Departments
Questions (196)
Michael McNamara
Question:196. Deputy Michael McNamara asked the Minister for Health the data obtained by his Department relating to self-harm presentations to emergency department per day and emergency department during the period 27 March to 31 August 2020, including the data collected and collated by the HSE National Clinical Programme for the Assessment and Management of Patients presenting to emergency departments following self-harm. [37302/20]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
Covid-19 Pandemic
Questions (197)
Michael McNamara
Question:197. Deputy Michael McNamara asked the Minister for Health the steps that have been taken to improve the quality of data on Covid-19 deaths both inside and outside of hospitals with respect to identifying persons for whom Covid-19 was the cause of death, a co-factor and a nosocomial infection, respectively. [37303/20]
View answerWritten answers
I have asked the HSE to respond to the deputy directly.
Covid-19 Tests
Questions (198)
Joe O'Brien
Question:198. Deputy Joe O'Brien asked the Minister for Health if consideration has been given to prioritising nursing and care home visitors for rapid Covid-19 testing when it becomes available in order to allow persons spend time with their loved ones; and if he will make a statement on the matter. [37317/20]
View answerWritten answers
The Health Service Executive has adopted RNA PCR as the gold standard test for diagnosing Covid-19 cases, as part of the HSE test and trace strategy, consistent with international best practice, and approved by NPHET. This platform is deployed in acute hospitals, the NVRL and HSE’s commercial partners. Given the volumes required, these operate as batch tests and hence take a number of hours depending on the platform and the volume being processed.
The HSE has worked intensively over the last number of months to put in place a comprehensive testing and tracing operation. We now have on-island capacity to test up to 126,000 people per week, which can be increased to 140,000 per week if the demand requires. It should be noted that testing for Sars-Cov2 does not confirm that an individual with a 'not detected' result is not incubating the infection or the level of virus is below detectable levels at the time of the test. It is for this reason, for example, that testing of close contacts of a confirmed case is carried out on two separate occasions, when they are first identified and again 7 days after their last contact with the person.
Ireland is pursuing a robust testing strategy under the guidance of the National Public Health Emergency Team (NPHET). On an ongoing basis, NPHET considers and reviews, based on public health risk assessments, how best to target testing to hunt the virus in populations where it’s most likely and where it will do most harm.
Many of the rapid Covid tests reported in the public domain and in the media which purport to offer a test result in minutes (for example antigen tests) lack the sensitivity and specificity required for healthcare. The HSE is constantly monitoring the sensitivity of all types of tests that are available (e.g. antigen and saliva tests) to ensure that, if deployed, they would be of appropriate quality and sensitivity. This issue continues to be monitored by the WHO, ECDC, HIQA, and the HSE Laboratory taskforce.
It should be noted that testing for Covid-19 only provides a point-in-time result. It confers no guarantee that an individual with a 'not detected' result is not incubating the infection or the level of virus is below detectable levels at the time of the test. It is for this reason, for example, that testing of close contacts of a confirmed case is carried out on two separate occasions, when they are first identified and again 7 days after their last contact with the person.
The testing strategy in use in Ireland remains under consideration by NPHET on an ongoing basis.
Drug and Alcohol Task Forces
Questions (199)
Niall Collins
Question:199. Deputy Niall Collins asked the Minister for Health the additional funding, assistance and resources he plans to provide to a service (details supplied) in 2021; if his attention has been drawn to the importance of the matter in the area; and if he will make a statement on the matter. [37330/20]
View answerWritten 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.
Addiction Treatment Services
Questions (200)
Thomas Gould
Question:200. Deputy Thomas Gould asked the Minister for Health the estimated cost of waiving the assessment fees for rehabilitative and detox treatment programmes. [37331/20]
View answerWritten answers
As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
Home Help Service
Questions (201)
Chris Andrews
Question:201. Deputy Chris Andrews asked the Minister for Health the reason the home help service in the Ringsend, Dublin 4 area is not being adequately funded resulting in the service not being able to take on new clients or to increase hours to existing clients; and if funding to this vital service will be increased to allow it to continue its work. [37335/20]
View answerWritten answers
As this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
Nursing Education
Questions (202)
Catherine Murphy
Question:202. Deputy Catherine Murphy asked the Minister for Health his plans to review and enhance student and intern nurses pay in view of the fact that many fourth-year students are due to sign work placement contracts in the coming weeks. [37354/20]
View answerWritten 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 arrangements 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.
Hospital Car Parks
Questions (203)
Neasa Hourigan
Question:203. Deputy Neasa Hourigan asked the Minister for Health his plans to introduce a cap on the maximum daily charge for parking at public hospitals for patients and visitors; his further plans to introduce flexible passes in all hospitals for patients and their families; and if he will make a statement on the matter. [37358/20]
View answerWritten answers
The Programme for Government makes a commitment to introduce a cap on the maximum daily charge for patients and visitors at all public hospitals where possible, and to introduce flexible passes in all public hospitals for patients and their families.
My Department and the HSE are currently engaging on this issue.
HSE National Service Plan
Questions (204)
Neasa Hourigan
Question:204. Deputy Neasa Hourigan asked the Minister for Health when the HSE service plan for 2021 will be published; and if he will make a statement on the matter. [37359/20]
View answerWritten answers
The Legislation (Health Act 2004 as amended) outlines the timeframes that must be adhered to in the publication of the National Service Plan. This outlines that my Department must write to the Health Service Executive to notify it of its allocation for 2021 not later than 21 days after the publication by the Government of the Estimates for Public Services. I formally notified the HSE of its Financial allocation in a ‘letter of Determination’ which issued on 3rd November 2020. The legislation further provides that, on receipt of the letter of this determination, the Executive has 21 days to prepare and submit its Service Plan for 2021 for my approval. For NSP 2021, the HSE are currently working to a deadline of 24November, however I can if required extend this deadline.
Following the submission of the service plan, the legislation provides 21 days for me to examine the proposed plan and either:
a) approve the service plan in the form it is submitted,
b) approve the service plan with such amendments as I, having consulted with the Executive, may determine, or
c) issue a direction to the Executive to amend the plan.
The National Service Plan must be laid before the Houses of the Oireachtas within 21 days of its approval. Once the Service Plan is laid before the Houses of the Oireachtas, the HSE will ensure it is published at the earliest possible time.
General Practitioner Services
Questions (205)
Róisín Shortall
Question:205. Deputy Róisín Shortall asked the Minister for Health the action his Department is taking to address the problem of poor general practitioner coverage in areas of disadvantage; his views on the adequacy of the current practice supports for premises in this regard: the progress in introducing salaried general practitioners as a means of addressing the issue; and if he will make a statement on the matter. [37360/20]
View answerWritten 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 to improve recruitment and retention in general practice.
These include changes 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. Supports for rural GP practices have been enhanced, while the Agreement also includes increased support for GPs working in disadvantaged urban areas.
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.
Improved family friendly arrangements are an important feature of the revised contractual arrangements, with an increase in the locum rate for maternity and paternity cover, and an increase in the paternity leave allowance from 3 days to 2 weeks.
In addition, 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.
I believe that these measures and supports will see a needed increase in the number of GPs working in the State, improving access to GP services for patients throughout the country.
GPs are private practitioners who hold contracts with the HSE to provide services under various public health schemes; there are no plans at present to directly employ general practitioners. The 2019 GP Agreement includes a commitment to undertake a strategic review of GP services within the lifetime of the Agreement, to examine how best to ensure the provision of GP services in Ireland for the future. The outcome of this review will inform future contractual changes, with preparatory work for the review having begun this year.
Health Services
Questions (206)
Róisín Shortall
Question:206. Deputy Róisín Shortall asked the Minister for Health the current resource allocation system in use to ensure health resources are allocated fairly and in proportion to need; and if he will make a statement on the matter. [37361/20]
View answerWritten answers
A clear governance and accountability framework was identified as a key building block of Sláintecare by the Committee on the Future of Healthcare. As part of its recommendations in this area, the Committee called for the HSE to become a more strategic and patient-focused ‘national centre’ carrying out national level functions, and the establishment of regional bodies with responsibility for the planning and delivery of integrated care at a regional level. The new Programme for Government, Our Shared Future, recommits to this Sláintecare recommendation, stating “Enhanced governance and accountability in the health service is a key component of Sláintecare reform. The HSE Board is now in place and we must now bring forward detailed proposals on the six new regional health areas to deliver services for patients locally that are safe, high quality and fairly distributed.”
As agreed, when the new Regional Health Areas geographies were announced last summer, a business plan for the establishment of these health areas was expected to be brought to Government for its approval in 2020. The intention was that this plan would set out the high-level organisational design for the health system, including: the respective roles, functions, responsibilities and accountabilities of the Department of Health, HSE centre and new regional structures; the relationship between these entities; and the overall legal construct. Work was underway in the Department of Health and the HSE to develop these detailed proposals, in consultation with stakeholders. Understandably, this work was paused as a result of COVID-19. This programme of work will be given further consideration to take account of the Programme for Government commitment and any new considerations relating to COVID-19.
The programme plan to support the development of the Regional Health Areas included a focus on the development of resource allocation modelling on the basis of population needs assessment. One of the goals of the regional devolvement of health services is the concept of “one region, one budget”. A key factor in implementing this goal will be determining the methodology and approach to the allocation of resources, on a population basis which takes account of need. Clearly, the way in which resources are allocated will be determined by the nature of services provided at national, regional and supraregional level, as well as the governance that determines the flow of resources. It is critical that the approach to resource allocation is equitable, quality-driven, responsive to population health needs, outcomes focussed and sets up regions to deliver best outcomes for available resources. This will be a significant undertaking but one that is critical to the reorganisation of the health and social care service and the operation of regional structures. The initial focus of this work will be on conducting an “as is” mapping of current resource allocation, learning from international approaches, feasibility and readiness assessment and stakeholder engagement. This will inform and enable work to then commence on specification of a geographic resource allocation formula.
Home Care Packages
Questions (207)
Seán Sherlock
Question:207. Deputy Sean Sherlock asked the Minister for Health if additional home support services specifically for Sundays will be provided for a person (details supplied) in County Cork; and if he will make a statement on the matter. [37363/20]
View answerWritten answers
As this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
Vaccination Programme
Questions (208)
Gary Gannon
Question:208. Deputy Gary Gannon asked the Minister for Health his views on reports of teachers having their 'flu jab cancelled to prioritise other types of front-line workers; and if he will make a statement on the matter. [37376/20]
View answerWritten answers
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. By providing vaccination to those most at-risk, and those most likely to require hospitalisation if they contract influenza, it is anticipated that the programme will see a reduction in the number of influenza-related hospital admissions, as well as a reduction in the overall spread of influenza in the community. This approach is in line with the advice of the National Immunisation Advisory Committee.
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 administration to all persons in an at-risk group, as well as 600,000 doses of the Live Attenuated Influenza Vaccine (LAIV) for all children aged from 2 to 12 years old inclusive.
As with other persons, teachers who are in an at-risk category, are eligible for vaccination without charge under the influenza vaccination programme. Those teachers not covered by the publicly funded influenza vaccination programme avail of influenza vaccination from GPs and pharmacists on a private basis.
1.3 million of the 1.35 million doses of flu vaccine available this winter have now 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. Given the situation on the international market, it is not likely that additional supply will be possible. 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.
Covid-19 Pandemic
Questions (209)
Gary Gannon
Question:209. Deputy Gary Gannon asked the Minister for Health if he considers teachers, SNAs and school staff to be front-line workers; and if he will make a statement on the matter. [37377/20]
View answerWritten answers
I would like to acknowledge and commend the incredible effort made in all school communities throughout the country to continue to operate during the Covid-19 pandemic in the safest manner possible. The strong belief that schools are places of education, equity, opportunity and healthcare is coupled with the belief that they are places of safety during Covid-19 with the clear focussed attention to mitigating measures and Infection Prevention and Control recommendations as laid out in the national guidance documents for the education sector.
You may wish to note that my Department has been working closely with the Department of Education and the HSE to enhance the public health response to Covid-19 within educational facilities and the HSE's Schools Working Group has supported this response through the provision of a Central Administration Team. The Schools Working Group has further supported the necessary communications and documents which have been required over the course of the return to school. Further information on the Health Protection Surveillance Centre's (HPSC) Guidance for the Education sector is available here:- https://www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/guidance/educationguidance/.
I would like to assure you that the HSE will continue to work with our educational partners advising parents, pupils and staff of the importance of adherence to national public health measures to ensure schools can remain open in a safe environment.
Measures such as those introduced at level 5 are aimed at limiting the spread and damage of COVID-19, and are necessary to protect what 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.