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Thursday, 10 Dec 2020

Written Answers Nos. 427-454

Healthcare Policy

Questions (429)

David Cullinane

Question:

429. Deputy David Cullinane asked the Minister for Health the reason the target percentage of patients undergoing a non-urgent colonoscopy within 13 weeks was changed from 70% to 65% in the 2020 HSE Services Plan; and if he will make a statement on the matter. [42724/20]

View answer

Written answers

The relationship between the Department and the HSE is set out in the Health Act 2004 (as amended).  Under the Act, the HSE Directorate is accountable to the Minister for the performance of its functions and those of the Executive, and the Director General is accountable to the Minister on behalf of the Directorate for the performance by the Directorate of its functions and those of the Executive.

The Department oversees the performance of the HSE in relation to the delivery of the services set out in its National Service Plan. This is achieved through an on-going monthly performance management process where the HSE reports against the targets set out in the Service Plan. Monthly high-level meetings between management in both organisations are held to discuss on-going or emerging performance issues and to determine actions to resolve and improve areas of concern.  There is also regular engagement between HSE and departmental officials on a wide range of issues to ensure compliance with policy objectives.

The 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 not later than 21 days after the publication by the Government of the Estimates for Public Services. 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 Ministerial approval.

In terms of colonoscopy services, a national programme was established in mid-2016 to coordinate several activities to improve endoscopy services. The Endoscopy Programme is housed within the Acute Operations Division of the HSE and the programme is overseen by the National Endoscopy Steering Group, which includes a Clinical Lead, Training Lead, Nurse Lead and Programme Manager. The team are supported by the National Endoscopy Working Group. The aim of the endoscopy programme is to improve the delivery of endoscopy services across all Hospital Groups. 

Health Services

Questions (430)

Róisín Shortall

Question:

430. Deputy Róisín Shortall asked the Minister for Health the procedure that occurs when a company that holds a HSE contract which it originally procured through a tendering process no longer wishes to hold the contract or ceases to be operational; if the contract must be offered to other parties included in the original tender; if not, if the company can nominate a group to which to transfer the contract; and if he will make a statement on the matter. [42725/20]

View answer
Awaiting reply from Department.

Covid-19 Pandemic

Questions (431)

Jackie Cahill

Question:

431. Deputy Jackie Cahill asked the Minister for Health if a Dublin-based Covid-19 test centre that was recently closed that processed Covid-19 tests from Clonmel, County Tipperary has been replaced by another laboratory; if this closure has resulted in testing ability being reduced; and if he will make a statement on the matter. [42729/20]

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 (432, 433)

Jackie Cahill

Question:

432. Deputy Jackie Cahill asked the Minister for Health his plans for redress for patients who received erroneous false negative Covid-19 test results; and if he will make a statement on the matter. [42730/20]

View answer

Jackie Cahill

Question:

433. Deputy Jackie Cahill asked the Minister for Health if false negative Covid-19 tests are resulting in the spread of Covid-19; and if he will make a statement on the matter. [42731/20]

View answer

Written answers

I propose to take Questions Nos. 432 and 433 together.

The Health Service Executive (HSE) 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 the National Public Health Emergency Team. 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. HSE guidelines also advise that anyone who has been tested in these circumstances should also restrict their movements for 14 days. 

Ireland is pursuing a robust testing strategy under the guidance of 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. The testing strategy in use in Ireland remains under consideration by NPHET on an ongoing basis.

Respite Care Services

Questions (434)

Pearse Doherty

Question:

434. Deputy Pearse Doherty asked the Minister for Health his plans to recommence respite service at Lifford Hospital; the time frame for resumption of this service; and if he will make a statement on the matter. [42758/20]

View answer

Written answers

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

Hospital Appointments Status

Questions (435)

Pearse Doherty

Question:

435. Deputy Pearse Doherty asked the Minister for Health when a person (details supplied) will receive a gynaecological appointment in Letterkenny University Hospital; and if he will make a statement on the matter. [42759/20]

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 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.

Hospital Waiting Lists

Questions (436)

Pearse Doherty

Question:

436. Deputy Pearse Doherty asked the Minister for Health the waiting times for gynaecological appointments in Letterkenny University Hospital for routine and urgent referrals in 2018, 2019 and to date in 2020, in tabular from. [42760/20]

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 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.

In addition 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 information requested by the Deputy concerning Letterkenny University Hospital gynaecology OPD waiting lists is outlined in the attached document.

Waiting Times

Question No. 437 answered with Question No. 423.

Cross-Border Health Initiatives

Questions (438)

Pearse Doherty

Question:

438. Deputy Pearse Doherty asked the Minister for Health the legislative basis and the provision of legislation upon which the decision to refuse a cross-border directive application was made for a person (details supplied) in County Donegal; and if he will make a statement on the matter. [42762/20]

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.

Health Services Provision

Questions (439)

Richard Boyd Barrett

Question:

439. Deputy Richard Boyd Barrett asked the Minister for Health if the National Gender Service recognises the WHO’s latest position on transgender persons that it has stopped classifying transgender persons as having a mental disorder since 25 May 2019; the locations of the HSE or National Gender Service clinics; the length of the waiting lists to attend; the number of persons on waiting lists for transgender services; if adult patients are asked to bring parents; the persons approved to attend with a minor; if transgender services are offered solely on a public basis; if there are private services available; if so, if they are they covered by private health insurance; and if he will make a statement on the matter. [42765/20]

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Written answers

In line with international trends, the demand for transgender services in Ireland has increased exponentially over the last number of years.  Services for transgender care have evolved organically over the last number of years, with adult services based in St. Columcille’s Hospital (part of Ireland East Hospital Group) and children’s services located in Our Lady’s Hospital for Sick Children, part of Children’s Health Ireland. Endocrinology and psychological support services are delivered on both sites. A model of care was developed to support the development of HSE gender identity services. The model of care was supported by the allocation of additional resources to enhance services.  

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.  

If the National Gender Service (NGS) identifies someone who is at high risk of harm with regard to their social health as a result of hormone therapy, then an individualised care plan is formulated to reduce this risk.  

This care plan may in some very specific instances include family meetings (with relevant family members such as parents). The NGS offers a variety of interventions to address any social health risk involving personal relationships. This can include family meetings at HSE offices, home visits from a member of the NGS team, family therapy, or/and individualised social work intervention (e.g. securing independent housing or income). The rationale of the care plan is explained to the individual during and following assessment. At all times during this process, data protection regulations are fully observed and all clinicians work in line with the relevant professional guidelines.  

This care plan can be experienced by the person attending the service as an insistence that they bring their parents with them to approve their plans for hormonal or surgical transition. However, parents have no say in the person's care. As long as the person has capacity to consent then they can proceed to medical intervention once they can say, based on clinical assessment, that the benefits will exceed the risks.  

If parents of patients are not supportive, or if the person does not want to involve their parents in their care, then the HSE works with them to secure independent income and housing prior to proceeding to a medical transition.  

Irish health insurers are required to have a standard minimum level of cover in every health insurance policy. These requirements are set out in the Minimum Benefit Regulations, made under the Health Insurance Acts. In addition to this minimum level of cover, it is open to insurers to provide cover for procedures beyond the requirements set out in governing legislation.  

The Minister for Health and I are committed to the development by the HSE of a well-governed and patient-centred health care service for adults and children in the transgender community. We will support the HSE in ensuring that people wishing to transition their gender have timely access to treatment that accords with international best practice.

Question No. 440 answered with Question No. 148.

Medicinal Products

Questions (441)

Cian O'Callaghan

Question:

441. Deputy Cian O'Callaghan asked the Minister for Health the counties in which PrEP is currently available; the steps he will take to ensure universal access for those for whom it is recommended; and if he will make a statement on the matter. [42776/20]

View answer

Written answers

Sexual health is a priority for my Department, as evidenced by the publication of the National Sexual Health Strategy 2015 - 2020. Significant progress has been made in the implementation of the Strategy’s key aims of reducing negative sexual health outcomes for everyone living in Ireland. Implementation of the Strategy is led by the HSE’s Sexual Health and Crisis Pregnancy Programme (SHCPP).

A key initiative under the Strategy was the provision of €5.4m funding for the establishment of a national programme of PrEP in 2019. This has been progressed, although the COVID-19 pandemic has led to interruptions to normal healthcare activity, with most services affected, including those providing PrEP.

Virtual clinics are held where possible, with attendance in person limited to appointment only. Service restrictions are predominantly due to social distancing requirements; waiting rooms can now only hold a fraction of patients compared to before the pandemic.

Phone lines, the GMHS website and other resources such as man2man.ie and sexual wellbeing.ie are regularly updated to reflect current service delivery and to signpost users to the HSE list of approved PrEP services. 

Although services have been subject to some Covid-19 related restrictions, the PrEP programme has continued to expand and over 2,000 individuals, mostly gay men, are currently registered on the national PrEP programme.  

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 (442)

Robert Troy

Question:

442. Deputy Robert Troy asked the Minister for Health if an appointment will be expedited for a person (details supplied). [42783/20]

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 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.

Health Services Provision

Questions (443)

Brendan Smith

Question:

443. Deputy Brendan Smith asked the Minister for Health when additional services will be provided at a healthcare facility (details supplied); and if he will make a statement on the matter. [42784/20]

View answer

Written answers

A 23-bed Intermediate Care Unit in Monaghan Hospital is planned as part of Winter Plan 2020 to provide step down beds for Cavan Hospital patients.  We are advised by the RCSI Hospital Group that 5 of these beds have opened recently and that the other 18 will open on a phased basis in the coming months..

Medical Cards

Questions (444)

Michael Healy-Rae

Question:

444. Deputy Michael Healy-Rae asked the Minister for Health if sativex will be covered under the medical card scheme; and if he will make a statement on the matter. [42785/20]

View answer

Written answers

The HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drug schemes, in accordance with the provisions of 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 licenced indications which have been granted market authorisation by the European Medicines Agency 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. 

HSE decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds, on the advice of the National Centre for Pharmacoeconomics (NCPE). The NCPE conducts health technology assessments (HTAs) for the HSE and makes recommendations on reimbursement to assist HSE decisions.

The HSE has advised that, in 2014, it notified the manufacturer of Delta-9-tetrahydrocannabinol/Cannabidiol, THC/CBD (Sativex®) that there was significant uncertainty around the cost-effectiveness of the medicine and as a consequence it did not support reimbursement of Sativex at that time.

In February 2018, the HSE received a revised application from the manufacturer for pricing / reimbursement of Sativex indicated as treatment for symptom improvement in adult patients with moderate to severe spasticity due to multiple sclerosis who have not responded adequately to other anti-spasticity medication and who demonstrate clinically significant improvement in spasticity-related symptoms during an initial trial of therapy.

In April 2018, the HSE commissioned a full HTA with respect to this indication. On 12 August 2019, the NCPE received the applicant's submission. The Health technology assessment  is currently ongoing at the NCPE. The output of this HTA will be an important input into the decision-making processes of the HSE.

The application for Sativex remains under consideration with the HSE and is being assessed in line with the 2013 Health Act.

Covid-19 Pandemic

Questions (445)

Gary Gannon

Question:

445. Deputy Gary Gannon asked the Minister for Health if student nurses and student healthcare workers will be prioritised for the Covid-19 vaccine based on occupational data from his Department (details supplied); and if he will make a statement on the matter. [42789/20]

View answer

Written answers

The COVID-19 Vaccine Allocation Strategy sets out a provisional priority list of groups for vaccination once a safe and effective vaccine(s) has received authorisation from the European Medicines Agency (EMA).

The Strategy was developed by the National Immunisation Advisory Committee (NIAC) and Department of Health, endorsed by the National Public Health Emergency Team (NPHET), and approved by Government on 8 December 2020.

The Allocation Framework was developed to consider how to prioritise different groups. It is based on (1) ethical principles and (2) epidemiological considerations, and takes account of the current and evolving understanding of distinctive characteristics of COVID-19 disease, its modes of transmission, the groups and individuals most susceptible to infection and the characteristics of the candidate vaccines. The primary aim of the allocation strategy is focus on the prevention of sickness and mortality, and to preserve the health of people, by prioritising those at highest risk.   

The Strategy is a further component to the State’s response to the COVID-19 pandemic, and will evolve and adapt with more detailed information on the vaccines and their effectiveness.

Further information on the Strategy can be found at:

https://www.gov.ie/en/publication/39038-provisional-vaccine-allocation-groups/

Speech and Language Therapy

Questions (446)

Róisín Shortall

Question:

446. Deputy Róisín Shortall asked the Minister for Health the current waiting time for a speech and language assessment in Dublin 9 and 11; if steps can be taken to improve on the waiting time of 12 to 18 months for an initial assessment; and if he will make a statement on the matter. [42790/20]

View answer

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

Health Services

Questions (447)

Holly Cairns

Question:

447. Deputy Holly Cairns asked the Minister for Health if all student occupational therapists, speech and language therapists and radiology students will be paid for the work they carry out in hospital and healthcare settings as part of mandatory placements; and if he will make a statement on the matter. [42791/20]

View answer

Written answers

Across the health and social care disciplines, there could be over 8,000 students on placement in hospital and healthcare settings.  Of this number, around a third are final year students.  The length of placements and the activities performed during these placements vary between the disciplines.  These students are not employees and in many cases the nature of the placement can, in the main, be limited to participation in an observing and a learning capacity. This is in line with other European countries.

There are no plans in place to pay students in health and social care professional roles for their time spent on placement as part of their academic course. 

Uniquely for student nurses and midwives there is, in the final year, a paid salary when they are specifically employed on an internship placement.  Student nurses and midwives’ final year internship placement consists of a continual 36-week rostered clinical placement, including annual leave. The internship placement is a paid placement as the student nurses and midwives take a reduced caseload. During these placements, students are under supervision and are considered as 0.5 WTE of the workforce.  In addition, Intern students can be allocated across all shift patterns including nights, weekends and 12-hour days. 

Prison Mental Health Services

Questions (448)

Holly Cairns

Question:

448. Deputy Holly Cairns asked the Minister for Health the steps he is taking to address the issues raised in relation to the care afforded to vulnerable prisoners, notably those with a mental illness in the Council of Europe anti-torture committee’s seventh periodic visit report on Ireland; and if he will make a statement on the matter. [42792/20]

View answer

Written answers

I welcome the recently published Final Report of the Council of Europe Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT), in respect of its last visit to Ireland in late 2019.  

The Department of Health has examined in detail the CPT Report. The overall thrust of the Report was favourable from a health sector point of view, which relates to Mental Health and Social Care. The CPT highlighted, for example, good Quality and Safety in the health facilities visited, including positive interactions between patients and staff.

There are, however, long acknowledged capacity issues in relation to the HSE National Forensic Mental Health Service (NFMHS).  These will be improved by the opening of the new NFMHS facility at Portrane next year, to replace the Central Mental Hospital, Dundrum.

In addition, the HSE is addressing other issues raised in the Report, such as:

- Improving links between the health and judicial system;

- Enhanced links between mental health and other care programmes or external agencies;

- Minimise use of restraint;

- Improve person-centred care, including peer and family supports; and

- Improve medication and record keeping practices. 

Health sector responses to the CPT Report, and to developing services generally, are also reflected in:

- Increased investment for Mental Health services arising from Budget 2021, and that envisaged over future years;

- Reform of Mental Health Act 2001;

- Implementation of Sharing the Vision, including a review of acute psychiatric bed capacity nationally;

- New Capacity/ Protection of Liberty safeguards;

- Reducing CAMHS admissions to adult units; and

- Improving Mental Health Tribunals/HSE Complaints systems.

The  recently launched “Programme for Government – Our Shared Future” is committed to further improvements for mental health, including the establishment of a high-level cross-departmental and cross-agency Taskforce to consider the mental health and addiction challenges of those imprisoned, and primary care support on release.

I will ensure that the health sector will continue to work closely with the CPT, and other international organisations, to improve mental health legislation, policies and services in Ireland over future years.

Mental Health Services

Questions (449)

Holly Cairns

Question:

449. Deputy Holly Cairns asked the Minister for Health the number of adults currently on waiting lists to see a psychiatrist in each of the HSE regions in County Cork; and if he will make a statement on the matter. [42794/20]

View answer

Written answers

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

Question No. 450 answered with Question No. 423.

Covid-19 Pandemic

Questions (451)

Louise O'Reilly

Question:

451. Deputy Louise O'Reilly asked the Minister for Health when local exercise classes that take place in local community centres will be allowed to reopen. [42804/20]

View answer

Written answers

The Government appreciates that there are many aspects of normal life that have been altered by the emergence of COVID-19, and the response that has been required. It also recognises that these changes are difficult for many people. However, it is the case at present that many of the things which we have previously taken for granted are no longer accessible in the same way due to the risks that they pose and the ease with which this virus spreads in particular conditions.

 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 a period of 6 – 9 months. 

The Plan aims to allow society and businesses to operate as normally as possible, while protecting 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.

The Plan consists of 5 levels. Each level sets out what is permitted for social or family gatherings, work and public transport, bars, hotels and restaurants, exercise activities and religious services, at that moment in time.  Each level contains a “basket” of measures which are intended, collectively, to contribute to lowering the risk of transmission of Covid-19 in alignment with the risk level at that time. The set of measures, individually, do not comprise a list of activities or places which are equally safe.  Instead, they are “baskets” of measures which are informed by public health understanding of the disease. The measures in place for each level reflect the prevailing disease situation and recognise that we can and must prioritise some activities over others. 

 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 numbers of people allowed to gather in different scenarios in the Government Plan 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.

Dance classes are regarded as exercise and sporting events under the Plan and where possible, such classes can be held online.

Under Levels 3, 4 and 5 indoor training is only permitted on an individual basis, therefore exercise and sporting events, including classes, cannot take place.

Under Level 2 restrictions, indoor classes, training and exercise can take place in pods of up to 6 people, once sufficient space is available and strict public health protocols are in place.

Under Level 1 of the Framework, there is no specific capacity limit, with capacity guided by what can be accommodated safely in the venue while ensuring all protective measures are in place, including social distancing.

Question No. 452 answered with Question No. 85.

Legislative Measures

Questions (453)

Pauline Tully

Question:

453. Deputy Pauline Tully asked the Minister for Health the position regarding the Mental Health (Amendment) Bill; and if he will make a statement on the matter. [42533/20]

View answer

Written answers

The Department of Health is currently finalising heads of bill to significantly amend and update mental health legislation, taking into account the 165 recommendations of the Expert Group Review of the 2001 Act, which was informed in part by a public consultation, a comprehensive submission by the Mental Health Commission, and Ireland’s domestic and international commitments, such as the Assisted Decision-Making (Capacity) Act 2015 and the UN Convention on the Rights of Persons with Disabilities.  The provisions of the Mental Health (Amendment) Act 2018 are also being incorporated into the draft heads of bill.

There are over one hundred sections in the draft heads. The Department has included detailed information under each head to allow for expert input from the Mental Health Commission and the HSE to be provided prior to publication, to allow the Department the opportunity to address any concerns as early as possible in the process. The draft heads of bill propose to extensively amend and update existing mental health legislation, moving from what has been described as a paternalistic approach in existing statute, to a more person-centred, human rights-based approach. The Department is currently awaiting further input from the HSE, which is expected in early December and plans to finalise the draft heads prior to submission for internal legal advice, and to the office of the Attorney General, as required, in early 2021.

A new Part of the Act related to children is being advanced separately, and the Department has approached the HSE, the Mental Health Commission, the Ombudsman for Children and the College of Psychiatrists for their expert opinions on the draft heads. The Department received the Mental Health Commission’s initial input in June 2020, and further observations in November. The Department expects to receive submissions from the other stakeholders in December 2020, and will then finalise the draft heads related to children at the same time as the rest of the heads.

Beef Environmental Efficiency Scheme

Questions (454)

Michael McNamara

Question:

454. Deputy Michael McNamara asked the Minister for Agriculture, Food and the Marine further to Parliamentary Question No. 894 of 17 November 2020, when an appeal will be processed for a person (details supplied); and if he will make a statement on the matter. [42568/20]

View answer

Written answers

I wish to inform the Deputy that the Agriculture Appeals Office operates independently of my Department.

I have been advised, however, that the records of the Agriculture Appeals Office indicate that a decision on the appeal of the named person was issued on 24th November 2020 and the person named was informed of the decision in writing.  The appeal is now closed.

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