Mental Health Services

Questions (657)

Alan Dillon

Question:

657. Deputy Alan Dillon asked the Minister for Health the number of vacant mental health staff posts in County Mayo in child mental health services; the details of each vacant post; the length of time each post has been vacant; the actions being taken to address issues with workforce planning in mental health services; and if he will make a statement on the matter. [7940/21]

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.

Mental Health Services

Questions (658)

Alan Dillon

Question:

658. Deputy Alan Dillon asked the Minister for Health the number of vacant mental health staff posts in County Mayo in adult mental health services per sector; the details of each vacant post; the length of time each post has been vacant; the actions being taken to address issues with workforce planning in mental health services; and if he will make a statement on the matter. [7941/21]

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.

Primary Care Services

Questions (659)

Alan Dillon

Question:

659. Deputy Alan Dillon asked the Minister for Health the number of children on primary care psychology waiting lists in County Mayo and CHO 2, respectively, in each of the years 2018 to 2020; and the length of time each child has been waiting. [7942/21]

View answer

Written answers (Question to Health)

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

Child and Adolescent Mental Health Services

Questions (660)

Alan Dillon

Question:

660. Deputy Alan Dillon asked the Minister for Health the number of children on CAMHS waiting lists in County Mayo and CHO 2, respectively, in each of the years 2018 to 2020; and the length of time each child has been waiting. [7943/21]

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.

Mental Health Services

Questions (661)

Alan Dillon

Question:

661. Deputy Alan Dillon asked the Minister for Health the number of mental health presentations to the accident and emergency department at Mayo University Hospital in each of the years 2018 to 2020, by whether the presentation was out of hours or not, age and gender in tabular form. [7944/21]

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.

Mental Health Services

Questions (662)

Alan Dillon

Question:

662. Deputy Alan Dillon asked the Minister for Health the progress of the recommendations reported by the national task force on youth mental health in tabular form; and if he will make a statement on the matter. [7945/21]

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.

HSE Waiting Lists

Questions (663)

Alan Dillon

Question:

663. Deputy Alan Dillon asked the Minister for Health the number of persons in County Mayo awaiting homecare support at 1 February 2021, in tabular form; and if he will make a statement on the matter. [7946/21]

View answer

Written answers (Question to Health)

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

Home Help Service

Questions (664)

Jackie Cahill

Question:

664. Deputy Jackie Cahill asked the Minister for Health if home help hours will be reviewed with a view to increasing them in the case of a person (details supplied); and if he will make a statement on the matter. [7947/21]

View answer

Written answers (Question to Health)

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

Home Help Service

Questions (665)

Jackie Cahill

Question:

665. Deputy Jackie Cahill asked the Minister for Health if home help hours will be reviewed with a view to increasing them in the case of a person (details supplied); and if he will make a statement on the matter. [7948/21]

View answer

Written answers (Question to Health)

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

Hospital Procedures

Questions (666, 667, 668)

John Lahart

Question:

666. Deputy John Lahart asked the Minister for Health if the HSE has cancelled all vaginal mesh procedures in its hospitals or hospitals under its management; if no private hospitals or clinics provide such vaginal mesh procedures in Ireland; and if he will make a statement on the matter. [7949/21]

View answer

John Lahart

Question:

667. Deputy John Lahart asked the Minister for Health the position regarding the recovery pathway for women recovering from vaginal mesh procedures which has left them debilitated in a myriad of ways; if a review of the HSE pathway for such patients has been undertaken to assess its effectiveness in terms of returning women to full health; if such procedures are carried out successfully in Ireland; if the HSE has investigated the sharing of information from UK and USA clinicians who have become specialist and recognised as such internationally; if his attention has been drawn to the fact that Irish patients who undertake the pathway to recovery in Ireland often feel that they are moved around in circles and often end up back with the clinician who told them in the first place that their symptoms were all in their mind; and if he will make a statement on the matter. [7950/21]

View answer

John Lahart

Question:

668. Deputy John Lahart asked the Minister for Health the steps taken in Ireland with regard to the Baroness Cumberledge report into the vaginal mesh issue; and if he will make a statement on the matter. [7952/21]

View answer

Written answers (Question to Health)

I propose to take Questions Nos. 666 to 668, inclusive, together.

I understand that complications from a mesh implant are very distressing and painful for those women involved. Ensuring that all women who develop mesh-related complications receive high quality, multi-disciplinary and patient-centred care is a priority for me and my Department. I would assure the Deputy that considerable work has been done to date in this country and continues to progress on patient safety in relation to mesh implants.

Uro-Gynaecological (Transvaginal) Mesh is used in the surgical treatment of Stress Urinary Incontinence (SUI) and Pelvic Organ Prolapse (POP) in women and such mesh devices have been widely used for this over the past two decades. Mesh devices continue to be placed on the market for use within the EU as they continue to be certified by European device regulatory competent authorities as being compliant with relevant EU legislation.

I am aware that in response to concerns raised in late 2017, the then Minister for Health requested the Chief Medical Officer (CMO) to prepare a report on the clinical and technical issues involved in ensuring both the safe and effective provision of mesh procedures in urogynaecology and an appropriate response to women who suffer complications. Published in November 2018, this report was informed by the available national and international evidence and the personal experiences of women who have suffered complications following mesh surgery.

In July 2018, in advance of publication of the full report, the CMO requested the HSE to pause all mesh procedures where clinically safe to do so. This pause remains in place.

The HSE published a detailed Implementation Plan for the recommendations in the report in April 2019. The National Women and Infants Health Programme is leading on this work. The HSE has created a dedicated webpage about vaginal mesh implants, including contact information regarding the pathways for women suffering complications. In addition, multidisciplinary specialist services are now available for women suffering from mesh complications across two sites at Cork University Hospital (CUMH) and National Maternity Hospital (NMH) Dublin . Both centres currently treat women suffering with post mesh complications and have been accepting referrals from the national pathway since it was set up in November 2018. Women referred to these centres are generally being seen within 3 months of referral, sometimes sooner. I am informed that it has been necessary for these clinics to be cognisant of the current COVID-19 public health guidance.

Funding has been provided in Budget 2021 to enhance and improve gynaecology services; this includes funding to further develop the multidisciplinary National Mesh Specialist Service, and to implement additional pelvic floor physiotherapy and clinical nurse specialist services in each maternity network. The development funding will support the ongoing work to implement the recommendations from the CMO’s Report.

Since the emergence of this matter, the ongoing priority focus for the Department and the HSE has been to meet the care needs of women experiencing mesh complications. I strongly encourage all women affected by mesh to engage with the relevant HSE contact points and the associated care pathways, to ensure that their service needs can be identified and provided for.

With regard to Baroness Cumberlege report, I am aware that in the UK, the Independent Medicines and Medical Devices Safety (IMMDS) Review chaired by Baroness Cumberlege, was established to examine how the UK healthcare system has responded to concerns raised by patients and families about three medical interventions, one of which was mesh.

The safety of mesh devices has been the focus of considerable regulatory, policy, clinical, and political scrutiny in many jurisdictions in recent years including the United States of America (USA), England, Scotland, Northern Ireland, Australia and other European countries, resulting in several safety reviews by regulatory bodies and other national health systems.

International evidence and learning play an important role in health policy considerations to promote safe, high quality care for patients. Any relevant learnings from the review will be taken into account as my Department continues to work with the HSE, the HPRA, and other stakeholders to support implementation of the recommendations of the CMO’s report on the use of use of Uro-Gynaecological Mesh in Surgical Procedures.

Women's health is a priority for this Government, as outlined in the Programme for Government. In relation to the wider work of my Department, Budget 2021 will provide a significant investment in services that are important to women, including gynaecology services. It will also provide a Women’s Health Fund which will support proposals arising from the work of the women’s health taskforce to improve women’s health outcomes and experiences of healthcare.

Hospital Waiting Lists

Questions (669)

Niamh Smyth

Question:

669. Deputy Niamh Smyth asked the Minister for Health the status of an appointment for a person (details supplied); and if he will make a statement on the matter. [7953/21]

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.

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.

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 Promotion

Questions (670)

Mary Lou McDonald

Question:

670. Deputy Mary Lou McDonald asked the Minister for Health the actions he has taken to progress the objectives set out in Breastfeeding in a Healthy Ireland, Health Service Breastfeeding Action Plan 2016-2021; the progress made to date on meeting these objectives; and if he will make a statement on the matter. [7956/21]

View answer

Written answers (Question to Health)

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

Health Promotion

Questions (671)

Mary Lou McDonald

Question:

671. Deputy Mary Lou McDonald asked the Minister for Health the engagement he has had to date with the national breastfeeding co-ordinator; and if he will make a statement on the matter. [7957/21]

View answer

Written answers (Question to Health)

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

Health Promotion

Questions (672)

Mary Lou McDonald

Question:

672. Deputy Mary Lou McDonald asked the Minister for Health the actions he has taken to progress the objectives set out in the Healthy Ireland framework and the National Maternity Strategy 2016-2026; the progress made to date on meeting these objectives; and if he will make a statement on the matter. [7958/21]

View answer

Written answers (Question to Health)

I am very happy to outline, for the Deputy, the significant progress which has been made to implement the Healthy Ireland Framework and the National Maternity Strategy.

Healthy Ireland

Healthy Ireland, A Framework for Improved Health and Wellbeing 2013-2025, is the national framework for action to improve the health and wellbeing of Ireland. The Framework is now past the mid-way point for implementation.

Since publication in 2013, there has been significant progress in implementation. This has included:

- A focus on building an enabling environment for cross-sectoral and collaborative action, supported by a stakeholder engagement and communications strategy.

- Significant cross government and intersectoral partnerships and working has been created by the Framework.

- A suite of national policies and plans to address risk factors such as obesity, tobacco and physical inactivity have been published, and policy direction across areas such as cancer, maternity care, drugs and mental health has been informed and influenced by Healthy Ireland.

Notwithstanding the progress to date, there is an urgent need to scale and expand the activity across all strands of the work, from Government to local level, to support effective implementation, and to capitalise on further opportunities to involve more sectors in implementation.

In late 2019, the Health and Wellbeing Unit in my Department commenced the development of a Strategic Action Plan for the next phase of the Healthy Ireland Framework. Despite the challenges caused by Covid-19, which has caused some delays to the original timeline for this process, significant progress on the development of the Strategic Action Plan for Healthy Ireland has been made. To date the process has already completed a rapid review of previous progress, extensive stakeholder engagement, a desktop review of other jurisdictions for best practice, and a review of goals for alignment with the Sustainable Development Goals and the Programme for Government.

Presently a set of emerging priorities is being considered in partnership with other Government Departments and internally in the Department of Health. The Healthy Ireland Strategic Action Plan is expected to be finalised in early 2021, for agreement across Government and subsequent publication.

National Maternity Strategy

The Programme for Government commits to 'Promoting Women’s Health' and Budget 2021 provides a very significant investment to deliver on this commitment. This includes funding of €12m to ensure a continued impetus to the implementation of the National Maternity Strategy and to improve gynaecology services. In addition, building on the work of the Women’s Health Taskforce, a €5m Women’s Health Fund was allocated in Budget 2021 to improve women’s health outcomes and experiences of healthcare.

As the Deputy is aware, the National Maternity Strategy was published in 2016. The Strategy aims to ensure that appropriate care pathways are in place in order that mothers, babies and families get the right care, at the right time, from the right team and in the right place. Similarly, the Strategy aims to increase choice for women whilst ensuring that services are safe, standardised and of the highest quality. It recognises that, while all pregnant women need a certain level of support, some will require more specialised care. Accordingly, at the Strategy’s core is an integrated model that delivers care at the lowest level of complexity and encompasses all the necessary safety nets in line with patient safety principles.

The phased implementation of the Strategy is being led by the National Women & Infants Health Programme (NWIHP). Development funding provided to the NWIHP in 2021 to progress the Strategy’s implementation will serve to:

- further develop community-based midwifery services;

- address deficits identified in HIQA inspection reports;

- improve access to specialist and allied health professional services and supports;

- strengthen training and education supports (e.g. CTG training).

- Further progress the roll out of the Maternal and Newborn Clinical Management System, which supports better, safer clinical decision-making and a more connected and integrated health service delivering improved health outcomes.

Notwithstanding the impact of COVID 19, work continued in 2020 to implement the Strategy and to further develop and expand community midwifery services, to facilitate the roll-out of the Supported Care Pathway and to enable women to avail of maternity care at the lowest level of complexity. In addition, the first National Maternity Experience Survey, a key recommendation of the Strategy, was conducted in 2020. The survey reports, published in October, were largely positive, and provide tangible evidence and rich qualitative information about what matters to women and their partners, and identifies, from their perspective, what areas require further focus and improvement.

Through the implementation of the National Maternity Strategy the quality and safety of our maternity services has improved. The Deputy can be assured that our maternity services are developing progressively and the benefits are being experienced by almost 80,000 families who access such services each year. Development funding has been provided for additional midwives, consultants, theatre staff, ultrasonographers and quality and safety managers; increasingly women have more choice in the service they receive with the development of community midwifery services and the availability of home from home birthing options; access to routine anomaly scanning has increased; Bereavement Teams are in place in every maternity unit; the perinatal mental health model of care is being implemented; all maternity hospitals/units now publish a Maternity Safety Statement on a monthly basis; and phase 1 of the roll-out of the Maternal and Newborn Clinical Management System has been completed.

The Strategy Implementation Plan is currently being reviewed by the NWIHP with a view to assessing the overall status of implementation and to provide up-to-date timelines for the individual recommendations. My Department will continue to work with the NWIHP in 2021 to support ongoing implementation of the Strategy.

Covid-19 Pandemic

Questions (673)

Michael Creed

Question:

673. Deputy Michael Creed asked the Minister for Health if he has considered monitoring the presence of Covid-19 in wastewater streams thereby securing significant data on emerging incidences of Covid-19 within the population or a region (details supplied); if his attention has been drawn to the fact that this is being carried out in several other European Union jurisdictions; and if he will make a statement on the matter. [7969/21]

View answer

Written answers (Question to Health)

At its meeting on 12 November 2020, the NPHET endorsed a paper “SARS-CoV-2 wastewater surveillance in Ireland” and recommended that the NVRL and HPSC work collaboratively to implement a national wastewater surveillance network for SARS-CoV-2. The paper is available online: https://www.gov.ie/en/collection/691330-national-public-health-emergency-team-covid-19-coronavirus/#november

Wastewater surveillance involves the analysis of SARS-CoV-2 genetic material in sewage samples which will capture both symptomatic and asymptomatic individuals in the community, providing an early warning system that will identify when SARS-CoV-2 levels are increasing in the community. This type of enhanced surveillance doesn't provide much additional information when there are high levels of virus circulating, but it can be an effective early warning system when there are low levels of circulating virus in the community.

An inter-agency wastewater surveillance group has been established and it is meeting weekly. Sampling is already being undertaken in Dublin and there is a plan in place to expand sampling to more than 60 wastewater treatment plants across all 26 counties.

Healthcare Policy

Questions (674)

Bernard Durkan

Question:

674. Deputy Bernard J. Durkan asked the Minister for Health the extent to which his Department has examined the vaping industry with a view to ensuring the highest possible health standards and the application of regulations deemed necessary; and if he will make a statement on the matter. [7971/21]

View answer

Written answers (Question to Health)

Electronic cigarettes are currently regulated in Ireland by the European Union (Manufacture, Presentation and Sale of Tobacco and Related Products) Regulations 2016 which transposed the EU Tobacco Products Directive. Under the Regulations, health warnings which advise consumers that electronic cigarettes contain nicotine are mandatory on packaging. Electronic cigarettes and refill containers must also be child and tamper-proof. The Regulations provide for mandatory safety and quality requirements for electronic cigarettes and refill containers, including maximum nicotine concentrations for electronic cigarettes containing nicotine, and maximum volumes for cartridges, tanks and nicotine liquid containers. The Regulations also require e-cigarette manufacturers or importers to notify the HSE of all products that they place on the market and of the ingredients contained in the product. If a manufacturer, importer or distributor has a reason to believe that a product is not safe, they are required to immediately notify the HSE and to explain what corrective action has been taken.

Further regulation of electronic cigarettes is planned for under the Public Health (Tobacco and Nicotine Inhaling Products) Bill. The Bill will introduce a mandatory licence for the retail sale of nicotine inhaling products and prohibit the sale of vaping products to, and by, persons under 18 years of age. The General Scheme of the Bill has been submitted for pre-legislative scrutiny to the Oireachtas Committee on Health and to the Office of the Attorney General for drafting of the Bill.

Dental Services

Questions (675)

Seán Canney

Question:

675. Deputy Seán Canney asked the Minister for Health the current waiting time for orthodontic assessments in County Galway; the number of patients waiting for an assessment; the number of patients on the orthodontic treatment waiting list; the waiting time for treatment; and if there are currently unfilled clinical positions in the service. [7977/21]

View answer

Written answers (Question to Health)

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

Audiology Services

Questions (676)

Seán Canney

Question:

676. Deputy Seán Canney asked the Minister for Health if audiology services have reopened and if clinics have recommenced in Tuam, County Galway; the status of a tender application for audiology testing facility in Tuam primary care centre, County Galway; and if he will make a statement on the matter. [7978/21]

View answer

Written answers (Question to Health)

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

Medical Cards

Questions (677)

Eoin Ó Broin

Question:

677. Deputy Eoin Ó Broin asked the Minister for Health if he will consider extending medical cards to cancer patients; the cost of doing so to all cancer patients without medical cards and all cancer party ends without medical cards and private health insurance. [7990/21]

View answer

Written answers (Question to Health)

Under the Health Act 1970 (as amended), eligibility for a medical card is based primarily on means. The Act obliges the HSE to assess whether a person is unable, without undue hardship, to arrange general practitioner services for himself or herself and his or her family, having regard to his or her overall financial position and reasonable expenditure. However, every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card and, in particular, to take full account of the difficult circumstances in the case of applicants who may be in excess of the income guidelines. The HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income threshold where they face difficult financial circumstances, such as extra costs arising from, the social and medical impacts of an illness.

The issue of granting medical cards based on having a particular disease or illness was previously examined in 2014 by the HSE Expert Panel on Medical Need and Medical Card Eligibility. The Group concluded that it was not feasible, desirable, nor ethically justifiable to list medical conditions in priority order for medical card eligibility. In following the Expert Group’s advice, a person’s means remains the main qualifier for a medical card. However, I also recognise that patients require a responsive and compassionate health system to meet their medical needs, particularly in cases of terminal illness. I am therefore pleased to confirm that the Government recently agreed to introduce an administrative arrangement for up to 12 months on an interim basis, that will enable persons who have been certified by their treating Consultant as having a prognosis of 24 months or less, to be awarded a medical card. These applications will not require a means assessment nor will they be reassessed.

Furthermore, since 2015 medical cards are awarded without the need of a financial assessment to all children under 18 years of age with a diagnosis of cancer, for a period of five years.

With regard to the estimated cost of providing a medical card in the manner sought, this information is not readily available at this time.

Hospital Car Parks

Question No. 679 answered with Question No. 633.

Questions (678)

Eoin Ó Broin

Question:

678. Deputy Eoin Ó Broin asked the Minister for Health if he will consider introducing a scheme to waive hospital car parking fees for cancer patients. [7991/21]

View answer

Written answers (Question to Health)

The Programme for Government makes a commitment to introduce a cap on the maximum daily charge for patients and visitors at all public hospitals, where possible and to introduce flexible passes in all public hospitals for patients and their families. My Department and the HSE are currently engaging on this issue in order to achieve this new Programme for Government commitment.

Question No. 679 answered with Question No. 633.

Health Services Provision

Questions (680)

Neale Richmond

Question:

680. Deputy Neale Richmond asked the Minister for Health when a service (details supplied) will reopen and resume its regular services; and if he will make a statement on the matter. [7997/21]

View answer

Written answers (Question to Health)

The Gay Men's Health Service is a community STI service and is managed through HSE Community Healthcare East (CHO6).

The COVID-19 pandemic has led to an unprecedented interruption to normal healthcare activity, with all services affected. The closure of the GMHS in 2020 related primarily to the necessary redeployment of increasing numbers of personnel to diverse COVID-19 related duties. Since the closure, significant efforts have been made to maintain service provision.

All health services are again facing restrictions, as the health system needs to prioritise treating those with COVID-19 and rolling out the vaccination programme. Notwithstanding these pressures, CHO6 are continuing to work to reopen the GMHS on a phased basis. The recruitment of permanent staff is progressing (with administrative staff in post) and IT expansion underway.

Existing PrEP users are now being facilitated in GMHS. The Clinic Consultant and other doctors are providing virtual consultations, and PrEP service users can also attend GMHS for STI screening and blood testing, with support from agency nurses. Those with diagnosed STIs will be treated in GMHS also.

Officials from my Department are in regular contact with the HSE to monitor progress on the phased reopening of the service.

Health Services Funding

Questions (681)

Michael Ring

Question:

681. Deputy Michael Ring asked the Minister for Health if additional funding has been provided for 2021 for a service (details supplied) in County Mayo. [7998/21]

View answer

Written answers (Question to Health)

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