Written Answers Nos. 552-571
552. Deputy Brendan Griffin asked the Minister for Health if a person (details supplied) will be referred for a hip replacement under the treatment purchase scheme; and if he will make a statement on the matter. [43221/20]
View answerIt 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.
The National Treatment Purchase Fund (NTPF) works with public hospitals, as opposed to with patients directly, to offer and provide the funding for treatment to clinically suitable long waiting patients who are on an inpatient/day case waiting list for surgery, having been referred on to such a list following clinical assessment by a consultant/specialist at an outpatient clinic.
The key criteria of the NTPF is the prioritisation of the longest waiting patients first. While the NTPF identifies patients eligible for NTPF treatment, it is solely on the basis of their time spent on the Inpatient/Daycase Waiting List. The clinical suitability of the patient to avail of NTPF funded treatment is determined by the public hospital.
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 waiting time experienced by the patient, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
555. Deputy Duncan Smith asked the Minister for Health if he will encompass emergency medical technicians, paramedics, advanced paramedics and so on who work with PHECC-approved voluntary organisations such as organisations (details supplied) under category 2 for the roll-out of the Covid-19 vaccine; if so, the way in which such persons will be identified; and if he will make a statement on the matter. [43233/20]
View answerThe 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.
With the benefit of the Vaccine Allocation Strategy approved by Government, the HSE, in conjunction with immunisation experts, is evaluating the further stratification and sequencing of cohorts for vaccination.
Further information on the Strategy can be found at: https://www.gov.ie/en/publication/39038-provisional-vaccine-allocation-groups/.
556. Deputy Brendan Griffin asked the Minister for Health if overnight respite care will be reinstated for a person (details supplied) in County Kerry; and if he will make a statement on the matter. [43243/20]
View answerThe Government is committed to providing services and supports for people with disabilities which will empower them to live independent lives, provide greater independence in accessing the services they choose, and enhance their ability to tailor the supports required to meet their needs and plan their lives.
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
557. Deputy Sean Sherlock asked the Minister for Health the number of students accepting Covid-19 tests in each third-level institution in which the HSE is offering mass Covid-19 testing in tabular form. [43248/20]
View answerIn Ireland, the National Testing Strategy for COVID-19 involves testing people who meet the case definition (people with symptoms), their identified close contacts, and established serial testing programmes. It is directed by the National Public Health Emergency Team (NPHET) and coordinated by the HSE.
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.
While there are no mass testing programmes in place nor plans to implement mass testing in third-level institutions as the Deputy describes, the HSE will offer Covid-19 testing in third level institutions in response to ongoing outbreaks in the student population. A Public Health Risk Assessment (PHRA) is undertaken and provides an opportunity for students to self-refer for Covid-19 testing. The decision to provide a similar testing facility at any other third-level educational institutes would be based on the undertaking of an appropriate risk assessment. The risk assessment applied in educational settings may be dynamic and change as new information becomes available, and the testing strategy may evolve as information unfolds.
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.
The testing strategy in use in Ireland remains under consideration by NPHET on an ongoing basis.
558. Deputy Peadar Tóibín asked the Minister for Health when a full-time child psychiatrist will be assigned to Limerick in addition to the one who travels from Dublin a couple of times a month. [43249/20]
View answerThe 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.
559. Deputy Róisín Shortall asked the Minister for Health his plans to work with an organisation (details supplied) as part of the roll-out of the Covid-19 vaccine programme; and if he will make a statement on the matter. [43251/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
560. Deputy Joe Flaherty asked the Minister for Health if consideration will be given to rolling out the Sligo scheme for cataract treatment nationwide (details supplied). [43258/20]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
561. Deputy Sean Sherlock asked the Minister for Health if carers will be specifically included in the vaccination allocation programme. [43260/20]
View answerThe 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.
With the benefit of the Vaccine Allocation Strategy approved by Government, the HSE, in conjunction with immunisation experts, is evaluating the further stratification and sequencing of cohorts for vaccination.
Further information on the Strategy can be found at: https://www.gov.ie/en/publication/39038-provisional-vaccine-allocation-groups/.
562. Deputy Sean Sherlock asked the Minister for Health the position in the vaccination allocation programme of persons under 18 years of age with underlying conditions. [43261/20]
View answerThe 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.
With the benefit of the Vaccine Allocation Strategy approved by Government, the HSE, in conjunction with immunisation experts, is evaluating the further stratification and sequencing of cohorts for vaccination.
Further information on the Strategy can be found at: https://www.gov.ie/en/publication/39038-provisional-vaccine-allocation-groups/.
563. Deputy Joe Flaherty asked the Minister for Health if a person (details supplied) can avail of a medical access programme licence. [43262/20]
View answerWhile the Department does not comment on individual cases the following information sets out the different pathways for a patient to access medical cannabis.
Medical Cannabis Access Programme (MCAP)
In June 2019, the Minister for Health signed legislation to underpin the operation of the Medical Cannabis Access Programme (MCAP). This is a 5-year pilot programme, restricted to prescribing of cannabis-based products by medical consultants, for patients with certain medical conditions who have exhausted all other available medical treatment options. Those conditions are:
- Spasticity associated with multiple sclerosis
- Intractable nausea and vomiting associated with chemotherapy
- Severe, refractory (treatment-resistant) epilepsy.
For more information relating to the MCAP, including FAQs, please see the Department of Health’s website at the following link: https://www.gov.ie/en/publication/90ece9-medical-cannabis-access-programme/
Commercial suppliers whose cannabis products have been reviewed and are considered to have met the specified requirements set out in the legislation and are in line with the clinical guidance for the MCAP, will have their products added to Schedule 1 of the Misuse of Drugs (Prescription and Control of Supply of Cannabis for Medical Use) Regulations 2019. Once the products are listed in Schedule 1 of these Regulations the suppliers will be permitted to supply these products to the Irish market, in line with legal and regulatory requirements. Cannabis products will only be listed in Schedule 1 of the Regulations once they have been assessed as suitable for medical use under the MCAP.
To date four products have been added to Schedule 1 of the Misuse of Drugs (Prescription and Control of Supply of Cannabis for Medical Use) Regulations 2019. The four products are:
1. Aurora High CBD Oil Drops
2. CannEpil ™
3. Tilray Oral Solution THC10:CBD10 25ml
4. Aurora Sedamen Softgels.
The HSE has engaged in discussions with the suppliers of these products, regarding pricing and supply information. The HSE will consider such information, in line with the Health (Pricing and Supply of Medical Goods) Act 2013. The programme will not become fully operational until pricing and supply matters are agreed.
Once the Medical Cannabis Access Programme commences the HSE will establish and maintain a Register to facilitate the enrolment and recording of certain data including patient identifiers (in anonymised format), prescribers enrolled in the Programme, as well as prescribed / supplied medical cannabis products. The Department can advise that while the MCAP register is not currently operational, engagement is ongoing with the HSE in regard to progressing same.
Ministerial Licence under Section 14 of the Misuse of Drugs Acts 1977-2016
Pending full operation of the MCAP and for medical indications not included in the MCAP, doctors may continue to utilise the Ministerial licencing route to prescribe medical cannabis for their patients, should they wish to do so.
In line with the Chief Medical Officer's advice, the granting of a licence for cannabis for medical purposes must be premised on an appropriate application being submitted to the Department of Health, which is endorsed by a consultant who is responsible for the management of the patient and who is prepared to monitor the effects of the treatment over time. This information can be found at the following links:
https://www.gov.ie/en/publication/1a5c4e-applying-to-the-minister-for-health-for-a-medical-cannabis-licence/
https://www.gov.ie/en/publication/e35cb4-ministerial-licence-application-process/
It is important to note that the medical decision to prescribe or not prescribe any treatment, including cannabis treatment, for an individual patient is strictly a decision for the treating clinician, in consultation with their patient. The Minister for Health has no role in this clinical decision-making process.
564. Deputy Ged Nash asked the Minister for Health his views on the strategy known as zero Covid; if his Department or NPHET has carried out an analysis on the feasibility of a zero-Covid strategy; if copies of advice NPHET provided to his Department on a zero-Covid strategy will be provided; and if he will make a statement on the matter. [43271/20]
View answerIt is appreciated that 2020 has been an incredibly difficult year for everyone and 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. Through our collective efforts, we have saved lives and limited the impact of the disease on society in Ireland. Furthermore, as part of the State's response to the COVID-19 pandemic, and subject to authorisation by the European Medicines Agency, the good news is that Ireland is on the cusp of deploying at least two COVID-19 vaccines as part of a national vaccination programme.
The Government has always been clear that a “zero covid” option is not one that is available to Ireland due to a number of factors, most pertinently the border with Northern Ireland. Our proximity to Europe and the nature of supply chains we are part of, both as an exporter and importer of vital goods, precludes such as approach. The clear advice from the National Public Health Emergency Team (NPHET) has been and continues to be that our overarching objective must be to suppress the virus to the lowest level possible and to maintain it at a low level. This is essential for protecting public health and our core priorities of education, health and social care services and protecting the most vulnerable to the disease.
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.
Information in relation to the public health measures in place at all levels of the Plan are available at: https://www.gov.ie/en/campaigns/resilience-recovery-2020-2021-plan-for-living-with-covid-19/
565. Deputy Ged Nash asked the Minister for Health if copies of all of the correspondence between NPHET and his Department that was used to consider the move to level 5 restrictions in October 2020 will be provided; and if he will make a statement on the matter. [43272/20]
View answerAll correspondence between the NPHET and the Minister for Health from the month of October has been published on the Department of Health website. Letters were sent to the Minister on 1, 4, 8,15 and 22 October and can be found at the following address:
https://www.gov.ie/en/collection/ba4aa0-letters-from-the-cmo-to-the-minister-for-health/#october
The letter of the 15th of October includes the recommendation to implement level 5 measures. For further information all minutes of meetings pertaining to the the same time period are available at the following address: https://www.gov.ie/en/collection/691330-national-public-health-emergency-team-covid-19-coronavirus/#october
566. Deputy Carol Nolan asked the Minister for Health the amount paid to a consultancy firm (details supplied) by his Department from 1 January 2019 to date in 2020; the reason for such contracts; and if he will make a statement on the matter. [43276/20]
View answerThe overall amount paid to the consultancy firm in question by the Department of Health from 01 January to 10 December 2020 is €296,980.99
Please find below a link to a breakdown of the contracts that contributed to this total.
a href="https://data.oireachtas.ie/ie/oireachtas/debates/questions/supportingDocumentation/2020-12-15_pq566-15-12-20_en.xlsx ">Amount paid</a>]
568. Deputy Denis Naughten asked the Minister for Health when under the Covid vaccination roll-out plan adults caring for vulnerable children will be vaccinated; his views on the need to vaccinate adults caring for vulnerable children; and if he will make a statement on the matter. [43283/20]
View answerThe 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.
With the benefit of the Vaccine Allocation Strategy approved by Government, the HSE, in conjunction with immunisation experts, is evaluating the further stratification and sequencing of cohorts for vaccination.
Further information on the Strategy can be found at: https://www.gov.ie/en/publication/39038-provisional-vaccine-allocation-groups/
571. Deputy Verona Murphy asked the Minister for Health if consideration has been given to including bipolar disorder among the diseases and disabilities covered by the long-term illness scheme; and if he will make a statement on the matter. [43293/20]
View answerThe Long Term Illness Scheme was established under Section 59(3) of the Health Act 1970 (as amended). The conditions covered by the LTI are: acute leukaemia; mental handicap; cerebral palsy; mental illness (in a person under 16); cystic fibrosis; multiple sclerosis; diabetes insipidus; muscular dystrophies; diabetes mellitus; parkinsonism; epilepsy; phenylketonuria; haemophilia; spina bifida; hydrocephalus; and conditions arising from the use of Thalidomide. Under the scheme, patients receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge.
Bipolar disorder is not included on the above list and there are no plans to extend the list of conditions covered by the scheme at this time. However, a review of the current eligibility framework, including the basis for existing hospital and medication charges, will be carried out under commitments given in the Sláintecare Implementation Strategy.
For people who are not eligible for the LTI Scheme, there are other arrangements which protect them from excessive medicine costs.
Under the Drug Payment Scheme, no individual or family pays more than €114 a month towards the cost of approved prescribed medicines. The scheme significantly reduces the cost burden for families and individuals with ongoing expenditure on medicines.
People who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be entitled to a medical card. In the assessment process, the HSE can take into account medical costs incurred by an individual or a family.
People who are not eligible for a medical card may still be able to avail of a GP visit card, which covers the cost of GP consultations.
