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Tuesday, 24 Nov 2020

Written Answers Nos. 778-794

Covid-19 Pandemic

Questions (778, 779, 780)

Louise O'Reilly

Question:

778. Deputy Louise O'Reilly asked the Minister for Health the scientific data underpinning the restrictions on and closure of a sector (details supplied). [37835/20]

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Louise O'Reilly

Question:

779. Deputy Louise O'Reilly asked the Minister for Health the incidence of Covid-19 caused by the operation of a sector (details supplied). [37836/20]

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Louise O'Reilly

Question:

780. Deputy Louise O'Reilly asked the Minister for Health if there are bespoke plans for a sector (details supplied) when Ireland egresses from the level 5 public health restrictions. [37837/20]

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Written answers

I propose to take Questions Nos. 778 to 780, inclusive, together.

As you will be aware, 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 Plan sets out Ireland's approach to managing and living with COVID-19 in a range of areas over the next 6 - 9 months.

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. It acknowledges that pubs and the hospitality sector are the world of work for so many in 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. 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.

At level 5 of the Plan, in order to reduce the person-to-person contacts which allow the virus to spread, wet pubs must remain closed, with take-away food and drink only, or delivery. I would like to assure you that measures such as this 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.

You may wish to note that the Health Information Quality Authority (HIQA) has recently published its advice for the National Public Health Emergency Team (NPHET) on the settings and activities which are associated with a higher risk of COVID-19 transmission. The publication of this advice is accompanied by a supporting evidence synthesis report which examined data from international sources and found that indoor, high occupancy, poorly ventilated environments, where there is shouting and singing, insufficient use of face coverings, and prolonged contact, present an increased risk of SARS-CoV-2 transmission. These findings support the NPHET’s current stance on settings, such as pubs, and activities such as drinking, which present a higher risk of transmission of Covid-19. HIQA's advice to the NPHET, Evidence Summary and supporting documentation is available at the following link:- https://www.hiqa.ie/reports-and-publications/health-technology-assessment/activities-or-settings-associated-higher-risk

I would also draw your attention to the CSO website for access to a range of data relating to Covid-19 including data on confirmed COVID-19 cases linked to pubs and the hospitality sector. This is available on the CSO Covid-19 Information Hub at www.cso.ie/en/releasesandpublications/ep/p-covid19/covid-19informationhub/ and, in particular, at https://www.cso.ie/en/releasesandpublications/br/b-cdc/covid-19deathsandcasesseries16/

A range of data on the epidemiology of Covid-19 in Ireland, including data on trends in transmission, is also published in the daily report by the Health Protection Surveillance Centre (HPSC) available at: www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/casesinireland/epidemiologyofcovid-19inireland, while a daily report on the last 14 days in cases available at: www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/casesinireland/epidemiologyofcovid-19inireland.

Further information on all levels of Resilience and Recovery 2020-2021: Plan for Living with COVID-19 is available at: https://www.gov.ie/en/campaigns/resilience-recovery-2020-2021-plan-for-living-with-covid-19/

Hospital Beds Closures

Questions (781)

David Cullinane

Question:

781. Deputy David Cullinane asked the Minister for Health the number of closed beds in the public health system by hospital and by categories of infection prevention and control, refurbishment, staffing shortages and other on 1 September, 1 October and 1 November 2020, respectively in tabular form; and if he will make a statement on the matter. [37838/20]

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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.

HSE Expenditure

Questions (782)

Michael Healy-Rae

Question:

782. Deputy Michael Healy-Rae asked the Minister for Health if he will provide a report on the amount spent by the HSE on public relations companies (details supplied); and if he will make a statement on the matter. [37849/20]

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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.

Vaccination Programme

Questions (783)

Charles Flanagan

Question:

783. Deputy Charles Flanagan asked the Minister for Health the reasons for the apparent cancellation of the school vaccine HPV programme in CHO8; and if he will make a statement on the matter. [37855/20]

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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.

Covid-19 Pandemic

Questions (784)

Jackie Cahill

Question:

784. Deputy Jackie Cahill asked the Minister for Health if the next of kin of residents in nursing homes can be allowed to visit on compassionate grounds if the resident has special needs and the lack of visits is affecting them mentally; and if he will make a statement on the matter. [37857/20]

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Written answers

The importance of continued social interaction of residents and their families cannot be overstated and every effort should be made, in line with public health advice, to ensure that these interactions continue, including through window visits.

Nursing home providers are ultimately responsible for the safe care of their residents. Under Regulation 11 of the Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2013 it is the legal responsibility of each registered provider to make arrangements for a resident to receive visitors, having regard to any risks that may present for the resident or other residents. Public health guidance has been developed in order to assist and support providers in this regard.

The current 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.

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 and to communicate with family and friends on an ongoing basis in order to support positive mental health and well-being.

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.

The current guidance notes that “Critical and compassionate circumstances are difficult to define and of necessity require judgement. The term should not be interpreted as limited to circumstances when the death of a resident is imminent.

Subject to a risk assessment in each case, other examples of critical and compassionate circumstances may include:

- Circumstances in which a resident is significantly distressed or disturbed and although unable to express the desire for a visit there is reason to believe that a visit from a significant person may relieve distress.

- When there is an exceptionally important life event for the resident (for example death of a spouse or birthday). - When the visitor may not have another opportunity to visit for many months or years or never (for example because they are leaving the country or are themselves approaching end of life)

- Increased visiting is recommended by their doctor as a non-pharmacological therapeutic alternative to an increased dose of an existing agent or introduction of a new anxiolytic or sedative agent.

- A resident expresses a strong sense of need to see someone whether for personal reasons, to make financial or other arrangements or to advocate on their behalf.

- A person nominated by the resident expresses concern that a prolonged absence is causing upset or harm to a resident.

- Other circumstances in which the judgement of the medical or nursing staff or social care worker caring for the resident is that a visit is important for the persons health or sense of well being.”

Separately, I understand that the Health Protection Surveillance Centre is currently reviewing the public health guidance on visiting, in consultation with relevant national stakeholders, to consider, in line with the range of public health factors, further potential for safe visiting within nursing homes. Visiting guidance is being considered in the context of the wider COVID-19 situation, as we plan and prepare for exiting level 5 restrictions.

Notwithstanding this, it is also important to be cognisant of the wider epidemiological situation and the risks associated with same. On the 19th November, the European Centre for Disease Control published its latest risk assessment with regard to long-term care facilities. It highlights that the probability of COVID-19 introduction into a long-term care facility depends on the level of COVID-19 circulation in the community, with a higher risk associated with higher incidence rates in the community.

This highlights the importance of suppressing the level of the virus in the community as one of the primary measures for protecting nursing homes. As citizens, we all have a responsibility in this regard and our actions across all of society can directly impact the outcomes for nursing home residents.

Information and Communications Technology

Questions (785)

Alan Kelly

Question:

785. Deputy Alan Kelly asked the Minister for Health the number of computers in the HSE that still use an operating system (details supplied) in tabular form; and if he will make a statement on the matter. [37869/20]

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Written answers

As the HSE has operational responsibility for ICT within the public health system, the Executive has been asked to reply directly to the Deputy.

Hospital Equipment

Questions (786)

Alan Kelly

Question:

786. Deputy Alan Kelly asked the Minister for Health the status of the upgrade of national integrated medical imaging system, NIMIS, radiology information system; and if he will make a statement on the matter. [37870/20]

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Written answers

As the HSE has operational responsibility for the NIMIS radiology system, the Executive has been asked to reply directly to the Deputy.

Cybersecurity Policy

Questions (787)

Alan Kelly

Question:

787. Deputy Alan Kelly asked the Minister for Health if the HSE hired consultants to advise it on IT security and cyberattacks; if so, the cost associated with same; and if he will make a statement on the matter. [37871/20]

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Written answers

As the HSE has operational responsibility for ICT within the public health system, the Executive has been asked to reply directly to the Deputy.

HSE Expenditure

Questions (788)

Alan Kelly

Question:

788. Deputy Alan Kelly asked the Minister for Health the amount the HSE has allocated and the amount it will spend on premium payments to a company (details supplied) in 2021; and if he will make a statement on the matter. [37872/20]

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Written answers

As the HSE has operational responsibility for ICT within the public health system, the Executive has been asked to reply directly to the Deputy.

HSE Staff

Questions (789)

Alan Kelly

Question:

789. Deputy Alan Kelly asked the Minister for Health the status of the recruitment campaign for a of head of information security, strategy and implementation within the HSE; and if he will make a statement on the matter. [37873/20]

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Written answers

I have asked the HSE to reply directly to the Deputy on this matter.

Maternity Services

Questions (790)

Darren O'Rourke

Question:

790. Deputy Darren O'Rourke asked the Minister for Health if consideration has been given to the establishment of a human milk bank here similar to a bank (details supplied) in County Fermanagh; and if he will make a statement on the matter. [37875/20]

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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.

Vaccination Programme

Questions (791)

Michael Healy-Rae

Question:

791. Deputy Michael Healy-Rae asked the Minister for Health if a vaccination for a person (details supplied) will be provided free of charge; and if he will make a statement on the matter. [37882/20]

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Written answers

The immunisation programme in Ireland is based on the advice of the National Immunisation Advisory Committee (NIAC). The committee's recommendations are based on the prevalence of the relevant disease in Ireland and international best practice in relation to immunisation. It makes recommendations on vaccination policy to my Department. The NIAC continues to revise recommendations to allow for the introduction of new vaccines in Ireland and to keep abreast of changes in the patterns of disease. Therefore, the immunisation schedule will continue to be amended over time.

In 2009, the NIAC recommended HPV (human papillomavirus) vaccination for all 12 to 13 year old girls to reduce their risk of developing cervical cancer when they are adults. In September 2010, the HPV vaccination programme was introduced for all girls in first year of secondary school.

The NIAC recommended that the HPV vaccine should also be given to boys. On foot of the NIAC’s recommendation, my Department asked the Health Information and Quality Authority (HIQA) to undertake a health technology assessment (HTA) to establish the clinical and cost-effectiveness of extending the current immunisation programme to include boys in the first year of secondary school.

The HIQA completed the HTA in December 2018, recommending that the HPV immunisation programme be extended to include boys. A policy decision was made to extend the HPV immunisation programme to include boys, starting in September 2019, with the introduction of a 9-valent HPV vaccine.

However, the HIQA report published in December 2018 did not recommend an HPV catch-up programme for older boys for the following reasons:

- vaccinating boys in the first year of secondary school provides the best possible protection against HPV infection;

- boys are already benefitting from the indirect herd protection provided by the girls' HPV vaccination programme which started in 2010.

The ages at which vaccines are recommended in the immunisation schedule are chosen by the NIAC in order to give each child the best possible protection against vaccine preventable diseases. As the HPV vaccine is preventative it is intended to be administered, if possible, before a person becomes sexually active, that is, before a person is first exposed to HPV infection.

Therefore, the gender-neutral HPV vaccination programme targets all girls and boys in first year of secondary school to provide maximum coverage. All vaccines administered through the School Immunisation Programme are provided free of charge.

My Department will continue to be guided by NIAC's recommendations on any emerging evidence on this issue in the future.

Anyone not in 1st year of secondary school or age equivalent in special schools or home schooled during the 2020/2021 school year who wishes to get the HPV vaccine, must go to their GP or sexual health clinic and pay privately for the vaccine and its administration.

Legislative Process

Questions (792)

Carol Nolan

Question:

792. Deputy Carol Nolan asked the Minister for Health the details of all applications made by his Department to the Oireachtas Business Committee to waive pre-legislative scrutiny of primary and secondary legislation sponsored or initiated by his Department from 1 January 2017 to date; the outcomes of such applications; and if he will make a statement on the matter. [37897/20]

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Written answers

The table below sets out the legislation sponsored or initiated by my Department from 1 January 2017 to date where a waiver in respect of Pre-Legislative Scrutiny was applied for. All applications were granted.

Applications for Pre-Legislative Scrutiny (1 January 2017 - 20 November 2020) (all granted)

General Scheme of the 2020 Brexit Omnibus Bill

Health Insurance (Amendment) Bill 2020

Health Insurance (Amendment) Bill 2019

Health Insurance (Amendment) Bill 2018

General Scheme of the National Research Ethics Committees Bill 2019

Health Service Executive (Governance) Bill

Heads of the CervicalCheck Tribunal Bill

Health (General Practitioner Service) Bill 2018

Legislation to amend the Mental Health Act 2001

Mental Health (Amendment) (No. 2) Bill 2017

Departmental Staff

Questions (793)

Patrick Costello

Question:

793. Deputy Patrick Costello asked the Minister for Health the grade at which the chief data protection officer in his Department is employed. [37927/20]

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Written answers

The Data Protection Officer at the Department of Health is employed at the grade of Assistant Principal.

Health Services

Questions (794)

Aengus Ó Snodaigh

Question:

794. Deputy Aengus Ó Snodaigh asked the Minister for Health if the drug Kaftrio has been rolled out for cystic fibrosis patients in Ireland; and if not, the reason. [37935/20]

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Written answers

The HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drugs schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013. In line with the 2013 Health Act and the national framework agreed with industry, a company must submit an application to the HSE to have a new medicine added to the reimbursement list.Reimbursement is for licensed indications which have been granted market authorisation by the European Medicines Agency (EMA) or the Health Products Regulatory Authority.In making a relevant reimbursement decision, the HSE is required under the Act to have regard to a number of criteria including efficacy, the health needs of the public, cost effectiveness and potential or actual budget impact.The HSE has advised that reimbursement was approved in October 2020 for Ivacaftor/ Tezacaftor/ Elexacaftor (Kaftrio®) in a combination regimen with ivacaftor 150 mg tablets for the treatment of cystic fibrosis (CF) in patients aged 12 years and older who are homozygous for the F508del mutation in the cystic fibrosis transmembrane conductance regulator (CFTR) gene or heterozygous for F508del in the CFTR gene with a minimal function (MF) mutation.This reimbursement approval is fully aligned with the EMA market authorisation which issued on 21 August 2020. Irish patients aged 12 years and older with CF and the above specified mutations, for which Kaftrio is licensed, will have reimbursement approval.HSE reimbursement of Kaftrio is administered under the High Tech Drug Arrangements. The High Tech Drug Arrangements provide for the supply of high-tech medicines through Community Pharmacies. The reimbursement of High Tech medicines is administered by the HSE through the Primary Care Eligibility & Reimbursement Service (PCERS).

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