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Wednesday, 16 Dec 2020

Written Answers Nos. 308-327

Departmental Correspondence

Questions (308)

Niamh Smyth

Question:

308. Deputy Niamh Smyth asked the Minister for Health if he will review correspondence (details supplied); if a reply will issue; the steps he is taking to address the matter; and if he will make a statement on the matter. [43765/20]

View answer

Written answers

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.

Question No. 309 answered with Question No. 285.

Hospital Appointments Status

Questions (310)

Maurice Quinlivan

Question:

310. Deputy Maurice Quinlivan asked the Minister for Health the reason for the delay in receiving a cataract surgery appointment in the case of a person (details supplied); and if he will make a statement on the matter. [43775/20]

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 (311)

Maurice Quinlivan

Question:

311. Deputy Maurice Quinlivan asked the Minister for Health the reason for the three year waiting time for obtaining an appointment for the removal of wisdom teeth at the oral and maxillofacial department at University Hospital Limerick for a person (details supplied); and if he will make a statement on the matter. [43776/20]

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.

Nursing Staff

Questions (312)

Robert Troy

Question:

312. Deputy Robert Troy asked the Minister for Health if there will be an increase in pensions for retired nursing staff given that this group have not seen an increase in pension rates in over ten years. [43780/20]

View answer

Written answers

The treatment of increases to certain public service pensions is provided for in the Department of Public Expenditure & Reform Circulars 20/2017, 2/2018 and 19/2019.

Under these circulars, a pension increase is applied only in circumstances where the current rate of pay for a serving employee exceeds the pay rate on which the retired staff member’s pension is based.

The HSE has been working to ensure that, where increases are due under the circulars, they have been applied at the correct point of pay restoration.

I have requested the HSE to respond directly to the Deputy providing timelines in relation to the processing of pension increases.

Maternity Services

Questions (313)

Neale Richmond

Question:

313. Deputy Neale Richmond asked the Minister for Health if consideration has been given towards lifting the restrictions on maternity services throughout Ireland; and if he will make a statement on the matter. [43828/20]

View answer

Written answers

I acknowledge that the visitor restrictions in our maternity hospitals, which were introduced because of Covid-19, are particularly difficult for expectant women and their partners. However, the restrictions, while very regrettable, are considered necessary to protect the safety of patients, the wellbeing of staff and the operability of our maternity services.

The National Women & Infants Health Programme has assured the Department that midwifery and obstetrical front-line staff are acutely aware of the important support provided by partners at the time of birth and that they wish to facilitate this support as far as possible.

The Health Protection Surveillance Centre has issued guidance regarding attendance at hospitals during the pandemic, which includes attendance at maternity hospitals. The guidance advises that restrictions on partner visiting; accompanying persons in labour; or parents visiting neonatal intensive care units, should be based on a documented risk assessment that is regularly reviewed. I am advised that any such decisions are informed by this guidance and with due regard to local circumstances, including infrastructure, local rates of community infection and infection rates in members of staff.

The Deputy may wish to note that the HSE has now re-classified partners as an ‘essential companion’ for the purpose of fetal anomaly or anatomy scans. The Department has been advised that the HSE has issued updated guidance to maternity hospitals, and the expectation is that commencing this week, partners’ attendance at fetal anomaly or anatomy scans will be facilitated, where possible, having regard to overall patient and staff safety.

However, it is important to emphasise that if a case of Covid-19 is linked to a maternity unit, Public Health teams will undertake a public health risk assessment, and it may be necessary to re-introduce restrictions.

Legislative Measures

Questions (314)

Joe Carey

Question:

314. Deputy Joe Carey asked the Minister for Health when the Disability Act 2005 will be fully commenced; and if he will make a statement on the matter. [43833/20]

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Written answers

The Disability Act (2005) has been commenced in full except for Part 2 which makes provision foran Assessment of Need, this section was commenced for children aged under the age of 5 in June 2007.

It was intended that the HSE would deliver Assessments of Need under the Disability Act for this age group and the Education for Persons with Special Education Needs Act (2004) (EPSEN) would provide assessments for school going children.

However, as a consequence of a High Court ruling of December 2009, the HSE extended eligibility to all children born after 1st June 2002.

Disability Support Services

Questions (315)

Joe Carey

Question:

315. Deputy Joe Carey asked the Minister for Health when he will legislate for personal assistance services as a right in law as per the motion unanimously supported by Dáil Éireann on 29 November 2019; and if he will make a statement on the matter. [43834/20]

View answer

Written answers

The Deputy refers to the motion put before the previous (32nd) Dail that seeks to ensure that the Government signs the optional protocol of the United Nation Convention on the Rights of Persons with Disabilities (UN CRPD) and create a "commissioner for independent living" to ensure that rights given under the UNCRPD regarding Personal Assistants are delivered to people with Disabilities.

Regarding the signing of the optional protocol, the Department of Justice had recommended that the Government would not consider opting into the Optional Protocol until the first reporting cycle of the Convention has been completed. That will provide a clearer picture of the obligations arising under the Convention and the Optional Protocol. Ireland has recently submitted its first national report, and our appearance before the UN Committee is likely to take place in mid 2022.

Regarding the provision of Personal assistance services for people with Disabilities, the Deputy will be aware that the area of disability services is a priority area for this Government. To support people with a disability, significant resources have been invested by the health sector in disability services, and the Government has ensured that an additional €100 million is being provided for new disability measures next year under Budget 2021. These measures will include an additional 80,000 personal assistant hours. The 2020 national service plan details that the HSE is seeking to deliver 1.67m hours of Personal Assistant Hours to over 2,550 people.

The Government is working to ensure that People with Disabilities be allowed to live an independent life of their own choosing, the same as any other person, and this is consistent with the disability reform policy - “transforming lives”.

The HSE provides a range of assisted living services including Personal Assistant (PA) services to support individuals to maximise their capacity to live full and independent lives.

Personal Assistance Services are accessed through an application process or through referrals from public health nurses or other community based staff. Individual’s needs are evaluated against the criteria for prioritisation for the particular services and then decisions are made in relation to the allocation of resources.

Resource allocation is determined by the needs of the individual, compliance with prioritisation criteria, and the level of resources available. It is important to note that the level of service delivered is varied to ensure that each client’s needs are reflected. Therefore there is no average agreed number of PA hours per person. PA and Home Support Services are provided either directly by the HSE or through a range of voluntary service providers. The majority of specialised disability provision (80%) is delivered through non-statutory sector service providers.

In line with Government policy, the HSE provides Personal Assistant Services that are person-centred, equitable and transparent to people with a physical and/or sensory disability.

People with disabilities are now living longer and living with a range of complex needs. In line with national policy implemented under Transforming Lives, the focus in recent years has been to enable people with disabilities to live lives of their choosing. The provision of Personal Assistant hours is an essential component of this.

The PA works on a one to one basis, in the home and the community, with a person with a physical or sensory disability. A vital element of this personalised support is the full involvement of the service user in planning and agreeing the type and the times when support is provided to them. Supporting independent living must enhance the person’s control over their own life.

Ireland ratified the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) in March 2018 as a process of progressive realisation of the rights that people with disabilities hold under the Convention. Significant progress has been made on key aspects of the CRPD, including enabling most children with disabilties to participate in mainstream education, providing supports for people with disabilities into employment, implementing a policy of decongregation and reforming the law on decision making capacity.

Article 19 of the UN Convention on the Rights of Persons with Disabilities states that

- disabled people should live where they wish and with whom they wish;

- they should enjoy a range of community support services including personal assistance;

- they should enjoy community life and its opportunities on an equal basis to non-disabled people; and

- they should not be subject to isolation or segregation.

The PA service provided by the HSE adheres to these principles. The Programme for Government, cognisant of these principles, agreed to deliver further increased Personal Assistance hours.

In the normal course of service delivery, an individual's requirements are constantly reviewed to ensure services meet changing need. An individual’s Personal Assistant hours may be adjusted following a service review where demand can result in one individual’s hours being reduced in order to address priority needs of other people with disabilities within that community.

This much needed flexibility gives local Community Healthcare Organisations (CHOs) the freedom to target Personal Assistant hours to maximum effect within their area.

Beyond the clear policy and operational arrangements, which I have outlined, and which facilitate the availability of appropriate and growing levels of Personal Assistant support, I have no plans for additional legislation governing the rights, entitlements and operations associated with this service at this time.

Dental Services

Questions (316)

Donnchadh Ó Laoghaire

Question:

316. Deputy Donnchadh Ó Laoghaire asked the Minister for Health the number of appointments under the school dental service in Cork city in each of the past 15 years by child. [43837/20]

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.

Dental Services

Questions (317)

Donnchadh Ó Laoghaire

Question:

317. Deputy Donnchadh Ó Laoghaire asked the Minister for Health the average age at which children had their first appointment under the school dental service in each of the past 15 years. [43838/20]

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.

Dental Services

Questions (318)

Donnchadh Ó Laoghaire

Question:

318. Deputy Donnchadh Ó Laoghaire asked the Minister for Health the average age at which children had their first appointment under the school dental service in Cork city in each of the past 15 years. [43839/20]

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.

Dental Services

Questions (319)

Donnchadh Ó Laoghaire

Question:

319. Deputy Donnchadh Ó Laoghaire asked the Minister for Health the number of dentists who have been employed for the school dental service in Cork in each of the past ten years. [43840/20]

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.

Dental Services

Questions (320)

Donnchadh Ó Laoghaire

Question:

320. Deputy Donnchadh Ó Laoghaire asked the Minister for Health if he will address a matter in relation to unfilled dentist vacancies (details supplied). [43841/20]

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.

Dental Services

Questions (321)

Donnchadh Ó Laoghaire

Question:

321. Deputy Donnchadh Ó Laoghaire asked the Minister for Health when it is expected to return to second class check-ups for school children under the school dentistry programme in Cork city. [43842/20]

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.

Dental Services

Questions (322)

Donnchadh Ó Laoghaire

Question:

322. Deputy Donnchadh Ó Laoghaire asked the Minister for Health when it is expected to return to fourth class check-ups for school children under the school dentistry programme in Cork city. [43843/20]

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.

Dental Services

Questions (323)

Donnchadh Ó Laoghaire

Question:

323. Deputy Donnchadh Ó Laoghaire asked the Minister for Health his views on whether in the absence of check-ups earlier in childhood, that a sixth class check-up will mean many dental hygiene issues with have been neglected or exacerbated and thereby harder to resolve. [43844/20]

View answer

Written answers

The HSE normally provides preventive care, screening and necessary interventions for permanent teeth, as well as referral for orthodontics and other secondary care, where appropriate, for school children at key stages of development - mainly in 2nd and 6th class and in 4th class where resources allow. The Covid-19 pandemic has impacted on the delivery of these services in 2020. Services are gradually resuming with priority being given to those that need to be seen urgently. Organisational and preventive measures related to Covid-19 have reduced throughput on resumption.

Smile agus Sláinte, the National Oral Health Policy, published by my Department in 2019, sets out the new model of care for delivery for dental services. The Policy is informed by the ‘life-course approach’, which supports the benefits of early intervention and provides for prevention and oral healthcare from birth into old age.

The new model of care will involve the introduction of oral healthcare packages, which will consist of examinations, assessments, advice, prevention interventions, emergency care and referral as appropriate. Eight oral health care packages will be provided for children from birth up to 16 years. Children under 6 years of age will be prioritised for the introduction of packages. The packages will be provided in a primary care setting by oral healthcare practitioners contracted by the HSE.

The timeframe for the delivery of all of the Policy, which will be rolled out incrementally, is up to 2026.

Dental Services

Questions (324)

Donnchadh Ó Laoghaire

Question:

324. Deputy Donnchadh Ó Laoghaire asked the Minister for Health if it is still his objective that children get a dental check-up at second class under the school dentistry programme. [43845/20]

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.

Dental Services

Questions (325)

Donnchadh Ó Laoghaire

Question:

325. Deputy Donnchadh Ó Laoghaire asked the Minister for Health if it is still his objective that children get a dental check-up at fourth class under the school dentistry programme. [43846/20]

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 (326)

Richard Boyd Barrett

Question:

326. Deputy Richard Boyd Barrett asked the Minister for Health if the Traveller community has been given consideration in the different levels of the vaccination roll out plan; the position of same if they are considered; and if he will make a statement on the matter. [43847/20]

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. Sequencing within and/or between cohorts, in line with the Vaccination Allocation Strategy, may be necessary due to the epidemiological situation at any given time, as well as the characteristics of the available vaccine(s), and as new data emerges, including the logistical challenges their distribution poses.

Further information on the Strategy can be found at:

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

Health Services Staff

Questions (327)

David Cullinane

Question:

327. Deputy David Cullinane asked the Minister for Health the number of approved filled by tenure permanent, temporary, locum, agency and vacant consultant posts by discipline and specialty; the length of time the vacant posts have remained vacant; and if he will make a statement on the matter. [43850/20]

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.

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