Covid-19 Pandemic

Question No. 517 answered with Question No. 484.

Question No. 518 answered with Question No. 511.

Questions (516)

Thomas Pringle

Question:

516. Deputy Thomas Pringle asked the Minister for Health if he will report on the way persons with disabilities are represented on advisory groups relating to the Covid-19 crisis; and if he will make a statement on the matter. [2425/21]

View answer

Written answers (Question to Health)

Central to the evolution of NPHET processes is the recognition that health and social care services, and indeed the wider cross-government COVID-19 response, have to become embedded and ‘mainstreamed’ in the usual operational response of organisations, as society adapts to the reality of living for the foreseeable future in the context of the COVID-19 pandemic.

In July 2020, as part of a process examining the work of all the subgroups of the NPHET, it was deemed that the Subgroup on Vulnerable Persons had met its Terms of Reference regarding preparedness plans being in place across government for vulnerable groups, and accordingly, it was stood down. The associated ongoing work was realigned into the appropriate policy and operational functions of the Department of Health or other relevant Departments, organisations, or bodies.

Recognising that vulnerable groups can be disproportionately affected by COVID-19 and as set out in Resilience and Recovery 2020-2021: Plan for Living with COVID-19, the Department of the Taoiseach has convened a Senior Official Group and sub-groups as needed, to drive implementation of the Plan. This includes a Sub-group on higher risk groups to monitor the spectrum of issues that need to be addressed in relation to groups at higher risk of COVID-19. These groups support the COVID-19 Oversight Group and the Cabinet Committee on the Government Response to COVID-19. The Subgroup on higher risk groups meets on a regular basis.

As part of the work of the Sub-group, relevant Departments have reviewed the oversight, management and reporting structures; guidance; mitigation plans; and communications structures in place for the various higher-risk groups.

The Departments represented on the Sub-group are responsible for the on-going monitoring of the epidemiological data and of any outbreaks in higher risk groups within their remit based on the Weekly Report prepared by the HPSC on Outbreaks/Clusters and sectoral information systems/knowledge. Upon the Sub-group’s establishment, Departments were also requested to ensure that they have early warning systems in place for their relevant sectors and groups to deal with emerging issues. Sectoral-specific actions are led by the relevant Departments. There is ongoing bilateral contact between the Department of the Taoiseach and Sub-group members to monitor the situation. The COVID-19 Oversight group is kept informed where additional cross-government measures are required. Persons with disabilities are represented on the Subgroup for higher risk groups through Department of Health officials. Interaction with groups and persons who represent those with disabilities takes place both through the Department of Health and the HSE.

In line with the above mechanism, the Department of Health monitors the impact of the pandemic on vulnerable groups on an ongoing basis based on reports provided by the HSE so as to identify, at an early stage, any issues or risks arising in relation to the COVID-19 impact on these groups. Regular bilateral engagement between the Department of Health and the Department of the Taoiseach through the cross-government mechanism for higher risk groups ensures the communication of relevant information in respect of outbreak control for nursing homes, the disability and mental health sectors, and in respect of drug and alcohol services. In addition to this ongoing monitoring, HSE Disabilities engage with the disability umbrella representative bodies on a frequent basis. Central to this joint effort is to ensure essential communication and joint working that delivers agreed measures to assist and support people with a disability, their families, and their communities.

The HSE Disabilities team created bespoke guidance for the sector arising from issues regarding the rights of disabled people due to restrictions, the specific needs of disabled people, and separate guidance was issued in relation to visiting in small group homes in the community. These guidance documents were developed following international research and intensive consultation with disabled people and the people who support them.

On 6th January last, the HSE issued revised guidance measures for Disability Services in the context of current high levels of COVID-19 transmission rates in the community. The revised guidance reflects Government’s intention that disability services will remain open at each level of the Resilience and Recovery Framework, subject to evolving public health guidance. The recent guidance is available at: https://www.hse.ie/eng/services/news/newsfeatures/covid19-updates/partner-resources/guidance-measures-for-disability-services-with-current-high-levels-of-covid-19-community-transmission.pdf

Service providers have been asked not to take unilateral action in relation to the provision of services and to ensure that robust communications plans are put in place to ensure that each service user and their families have a clear understanding of services to be provided during this current phase.

The Department, the HSE, and the HIQA will continue interagency collaboration, working together to monitor the impact of COVID-19 on those living with a disability and mitigate against associated risks. The Department of Health has and will continue to apprise the NPHET on vulnerable group issues on a regular basis.

I trust that the above information addresses the Deputy’s question satisfactorily.

Question No. 517 answered with Question No. 484.
Question No. 518 answered with Question No. 511.

Vaccination Programme

Question No. 520 answered with Question No. 448.

Questions (519)

Neasa Hourigan

Question:

519. Deputy Neasa Hourigan asked the Minister for Health his plans for persons who are accessing day services and are cared for by home carers over 65 years of age to be vaccinated for Covid-19; the timeline for same; and if he will make a statement on the matter. [2434/21]

View answer

Written answers (Question to Health)

The COVID-19 Vaccine Allocation Strategy sets out a provisional list of groups for vaccination. The Strategy was developed by the National Immunisation Advisory Committee (NIAC) and my Department, endorsed by the National Public Health Emergency Team (NPHET), and approved by Government on 8 December 2020.

Vaccine allocation is a matter for my Department and further information is available here: https://www.gov.ie/en/publication/39038-provisional-vaccine-allocation-groups/.

The rollout of the COVID-19 vaccination programme is the responsibility of the HSE.

The aim of the COVID-19 vaccination programme is to ensure, over time, that vaccine will become available to vaccinate all of those for whom the vaccine is indicated. Given that there will be initially limited vaccines available, it will take some time for all to receive those vaccines and that has necessitated an allocation strategy to ensure that those most at risk of death and serious illness receive the vaccine first.

The priority is to first vaccinate and protect directly the most vulnerable amongst us, that is, those most likely to have a poor outcome if they contract the virus. The priority is to directly use vaccines to save lives and reduce serious illness, hence the focus on the over 65 year old cohort in long term residential care facilities, and healthcare workers in frontline services often caring for the most vulnerable.

The next group to be vaccinated are those aged 70 and older and living in the community.

All of the groups will be covered as further vaccine supplies become available and the immunisation programme is rolled out nationally.

The evidence will be kept under review and the allocation groups may be updated, where necessary, in light of new evidence.

The timing of vaccination will be subject to vaccine supply, and the characteristics of the different vaccine products will impact on logistics and the settings in which vaccines can be administered.

Question No. 520 answered with Question No. 448.

National Public Health Emergency Team

Question No. 522 answered with Question No. 484.

Question No. 523 answered with Question No. 448.

Question No. 524 answered with Question No. 469.

Question No. 525 answered with Question No. 484.

Questions (521)

Neasa Hourigan

Question:

521. Deputy Neasa Hourigan asked the Minister for Health if he will reinstate the NPHET subgroup for vulnerable persons to interact with groups and persons who represent those with disabilities in the planning for Covid-19. [2436/21]

View answer

Written answers (Question to Health)

Central to the evolution of NPHET processes is the recognition that health and social care services, and indeed the wider cross-government COVID-19 response, have to become embedded and ‘mainstreamed’ in the usual operational response of organisations, as society adapts to the reality of living for the foreseeable future in the context of the COVID-19 pandemic.

In July 2020, as part of a process examining the work of all the subgroups of the NPHET, it was deemed that the Subgroup on Vulnerable Persons had met its Terms of Reference regarding preparedness plans being in place across government for vulnerable groups, and accordingly, it was stood down. The associated ongoing work was realigned into the appropriate policy and operational functions of the Department of Health or other relevant Departments, organisations, or bodies.

Recognising that vulnerable groups can be disproportionately affected by COVID-19 and as set out in Resilience and Recovery 2020-2021: Plan for Living with COVID-19, the Department of the Taoiseach has convened a Senior Official Group and sub-groups as needed, to drive implementation of the Plan. This includes a Sub-group on higher risk groups to monitor the spectrum of issues that need to be addressed in relation to groups at higher risk of COVID-19. These groups support the COVID-19 Oversight Group and the Cabinet Committee on the Government Response to COVID-19. The Subgroup on higher risk groups meets on a regular basis.

As part of the work of the Sub-group, relevant Departments have reviewed the oversight, management and reporting structures; guidance; mitigation plans; and communications structures in place for the various higher-risk groups.

The Departments represented on the Sub-group are responsible for the on-going monitoring of the epidemiological data and of any outbreaks in higher risk groups within their remit based on the Weekly Report prepared by the HPSC on Outbreaks/Clusters and sectoral information systems/knowledge. Upon the Sub-group’s establishment, Departments were also requested to ensure that they have early warning systems in place for their relevant sectors and groups to deal with emerging issues. Sectoral-specific actions are led by the relevant Departments. There is ongoing bilateral contact between the Department of the Taoiseach and Sub-group members to monitor the situation. The COVID-19 Oversight group is kept informed where additional cross-government measures are required. Persons with disabilities are represented on the Subgroup for higher risk groups through Department of Health officials. Interaction with groups and persons who represent those with disabilities takes place both through the Department of Health and the HSE.

In line with the above mechanism, the Department of Health monitors the impact of the pandemic on vulnerable groups on an ongoing basis based on reports provided by the HSE so as to identify, at an early stage, any issues or risks arising in relation to the COVID-19 impact on these groups. Regular bilateral engagement between the Department of Health and the Department of the Taoiseach through the cross-government mechanism for higher risk groups ensures the communication of relevant information in respect of outbreak control for nursing homes, the disability and mental health sectors, and in respect of drug and alcohol services. In addition to this ongoing monitoring, HSE Disabilities engage with the disability umbrella representative bodies on a frequent basis. Central to this joint effort is to ensure essential communication and joint working that delivers agreed measures to assist and support people with a disability, their families, and their communities.

The HSE Disabilities team created bespoke guidance for the sector arising from issues regarding the rights of disabled people due to restrictions, the specific needs of disabled people, and separate guidance was issued in relation to visiting in small group homes in the community. These guidance documents were developed following international research and intensive consultation with disabled people and the people who support them.

On 6th January last, the HSE issued revised guidance measures for Disability Services in the context of current high levels of COVID-19 transmission rates in the community. The revised guidance reflects Government’s intention that disability services will remain open at each level of the Resilience and Recovery Framework, subject to evolving public health guidance. The recent guidance is available at: https://www.hse.ie/eng/services/news/newsfeatures/covid19-updates/partner-resources/guidance-measures-for-disability-services-with-current-high-levels-of-covid-19-community-transmission.pdf.

Service providers have been asked not to take unilateral action in relation to the provision of services and to ensure that robust communications plans are put in place to ensure that each service user and their families have a clear understanding of services to be provided during this current phase.

The Department, the HSE, and the HIQA will continue interagency collaboration, working together to monitor the impact of COVID-19 on those living with a disability and mitigate against associated risks. The Department of Health has and will continue to apprise the NPHET on vulnerable group issues on a regular basis.

I trust that the above information addresses the Deputy’s question satisfactorily.

Question No. 522 answered with Question No. 484.
Question No. 523 answered with Question No. 448.
Question No. 524 answered with Question No. 469.
Question No. 525 answered with Question No. 484.

Covid-19 Pandemic

Questions (526, 528)

Catherine Murphy

Question:

526. Deputy Catherine Murphy asked the Minister for Health the advice he has taken regarding the issue of ventilation of indoor commercial spaces and the spread of Covid-19; if he will seek such advice with a view to engaging with various sectors, given that it is now known this virus is airborne and is likely to be in circulation for some time; and if he will make a statement on the matter. [2450/21]

View answer

Catherine Murphy

Question:

528. Deputy Catherine Murphy asked the Minister for Health if he has sought advice from NPHET on the issue of ventilation given that Covid-19 is now understood to be airborne; the reason specific strategies such as the installation of CO2 sensors and advice on good ventilation are not part of the routine advice to households and commercial establishments; and if he has not sought this advice, if he will do so. [2454/21]

View answer

Written answers (Question to Health)

I propose to take Questions Nos. 526 and 528 together.

The NPHET keeps all issues in relation to COVID-19 under review, including modes of transmission and the role that ventilation can play in mitigating transmission. These matters were discussed most recently at its meeting of 14th January.

COVID-19 is a new disease, and the effect of ventilation on the transmissibility of SARS-CoV-2 (the virus that causes COVID-19) is still unclear, however there is evidence that COVID-19 outbreaks are more commonly associated with crowded indoor spaces, and that poor ventilation may increase the risk of transmission in such settings.

There is already a range of advice and guidance in place in relation to ventilation. The Health Protection Surveillance Centre has published Guidance on Non-Healthcare Building Ventilation during COVID-19 which provides an analysis of the current literature examining the association between ventilation and COVID-19. The Guidance provides recommendations, based on the literature, for commercial and public buildings, including with regard to mechanical ventilation. It also includes school specific guidance which recommends the use of indoor air quality meters which monitor the level of CO2 in classrooms that rely on natural ventilation. This guidance can be found at the following link:

https://www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/guidance/educationguidance/Guidance%20on%20non%20HCbuilding%20ventilation%20during%20COVID-19.pdf

The HPSC is currently reviewing this guidance based on a recent HIQA rapid review of current public health guidance for community settings for COVID-19 and recent updates in similar international guidance, and it is expected that the updated guidance will be published soon.

Additional guidance on ventilation in commercial spaces is available in the Work Safely Protocol (https://enterprise.gov.ie/en/Publications/Publication-files/Work-Safely-Protocol.pdf) and in NSAI guidance for the retail sector and shopping centres:

https://www.nsai.ie/images/uploads/general/NSAI-COVID19-Retail-Guidelines-13012021.pdf

https://www.nsai.ie/images/uploads/general/NSAI-COVID19-Shopping-Centre-Guidelines-13012021.pdf

There is also additional guidance on Gov.ie and on the HSE website which outlines the importance of ventilation in households, this can be found here:

https://www.gov.ie/en/publication/472f64-covid-19-coronavirus-guidance-and-advice/

https://www2.hse.ie/conditions/coronavirus/how-coronavirus-is-spread.html

Eating Disorders

Question No. 528 answered with Question No. 526.

Questions (527)

Mark Ward

Question:

527. Deputy Mark Ward asked the Minister for Health the number of persons who presented with eating disorders to community healthcare teams relating to referrals in each of the years 2018 to 2020; the gender, age profile and county of residence of each in tabular form; and if he will make a statement on the matter. [2452/21]

View answer

Written answers (Question to Health)

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. 528 answered with Question No. 526.

Hospital Waiting Lists

Question No. 530 answered with Question No. 448.

Questions (529)

David Cullinane

Question:

529. Deputy David Cullinane asked the Minister for Health the number of persons on waiting lists for each discipline, speciality and sub-speciality for each hospital; the number waiting according to the same monthly categories issued by the National Treatment Purchase Fund, NTPF, on the basis of the December 2020 waiting list figures; and if he will make a statement on the matter. [2455/21]

View answer

Written answers (Question to Health)

It is recognised that waiting times for scheduled appointments and procedures have been impacted in the last year as a direct result of the COVID-19 pandemic.

Further to the deferral of most scheduled care activity in March, April, and May of last year due to the pandemic, the HSE is currently recommending that only critical time dependent elective procedures are undertaken at this time due to the on-going and significant increased demand for bed capacity related to Covid-19.

This decision was made arising from the rapid increase in Covid-19 admissions and to ensure patient safety and that all appropriate resources were made available for Covid-19 related activity and time-critical essential work.

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.

In relation to the information requested by the Deputy, the attached spreadsheets outline the Inpatient and Day Case (IPDC) waiting list by hospital, the IPDC waiting list by specialty, the Outpatient (OPD) waiting list by hospital and the Outpatient waiting list by specialty at the end of December 2020. This information is also available on the National Treatment Purchase Fund (NTPF) website https://www.ntpf.ie/home/nwld.htm, where the breakdown by specialty for each hospital is also available.

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Table 4

Question No. 530 answered with Question No. 448.