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Wednesday, 17 Feb 2021

Written Answers Nos. 732-756

Vaccination Programme

Questions (732)

Denis Naughten

Question:

732. Deputy Denis Naughten asked the Minister for Health the options available to a student (details supplied) who was unable to avail of the human papillomavirus, HPV, vaccine but now wishes to do so; and if he will make a statement on the matter. [8201/21]

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Written answers

The immunisation programme in Ireland is based on the advice of the National Immunisation Advisory Committee (NIAC). The committee's recommendations are based on the prevalence of the relevant disease in Ireland and international best practice in relation to immunisation. It makes recommendations on vaccination policy to my Department. The NIAC continues to revise recommendations to allow for the introduction of new vaccines in Ireland and to keep abreast of changes in the patterns of disease. Therefore, the immunisation schedule will continue to be amended over time.

In 2009, the NIAC recommended HPV (human papillomavirus) vaccination for all 12 to 13 year old girls to reduce their risk of developing cervical cancer when they are adults. In September 2010, the HPV vaccination programme was introduced for all girls in first year of secondary school.

Therefore, the gender-neutral HPV vaccination programme targets all girls and boys in first year of secondary school to provide maximum coverage. All vaccines administered through the School Immunisation Programme are provided free of charge.

The ages at which vaccines are recommended in the immunisation schedule are chosen by the NIAC in order to give each child the best possible protection against vaccine preventable diseases. As the HPV vaccine is preventative it is intended to be administered, if possible, before a person becomes sexually active, that is, before a person is first exposed to HPV infection.

My Department will continue to be guided by NIAC's recommendations on any emerging evidence on this issue in the future.

Anyone not in 1st year of secondary school or age equivalent in special schools or home schooled during the 2020/2021 school year who wishes to get the HPV vaccine, must go to their GP or sexual health clinic and pay privately for the vaccine and its administration.

Covid-19 Pandemic

Questions (733)

Róisín Shortall

Question:

733. Deputy Róisín Shortall asked the Minister for Health if mop-up clinics are currently under way in nursing homes that will enable residents to receive a second vaccine (details supplied); when every nursing home resident will receive the second vaccine; the process which applies if a nursing home resident cannot receive the vaccine within the recommended 21-day period; if they will have to start the vaccination process again; and if he will make a statement on the matter. [8214/21]

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 (734)

Mary Lou McDonald

Question:

734. Deputy Mary Lou McDonald asked the Minister for Health the position of persons with chronic kidney disease on the Covid-19 vaccine allocation strategy priority list of groups for vaccination. [8216/21]

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Written answers

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 in the following order: 85 and older, 80-84, 75-79, and 70-74. Vaccination of this group will begin in this month.

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.

Nursing Staff

Questions (735)

Johnny Mythen

Question:

735. Deputy Johnny Mythen asked the Minister for Health the number of vacant nursing positions by grade at Wexford General Hospital; and if he will make a statement on the matter. [8221/21]

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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.

Covid-19 Pandemic

Questions (736)

Neale Richmond

Question:

736. Deputy Neale Richmond asked the Minister for Health if family carers will be vaccinated as a specific group; and if he will make a statement on the matter. [8246/21]

View answer

Written answers

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 in the following order: 85 and older, 80-84, 75-79, and 70-74. Vaccination of this group will begin this month.

Family carers are a diverse group, therefore, each individual will be vaccinated in the group that is appropriate to them.

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.

Covid-19 Pandemic

Questions (737, 784)

Neale Richmond

Question:

737. Deputy Neale Richmond asked the Minister for Health if he has engaged with the national immunisation advisory committee, NIAC, on the vaccination of family carers; and if he will make a statement on the matter. [8247/21]

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Cormac Devlin

Question:

784. Deputy Cormac Devlin asked the Minister for Health if he will request the National Immunisation Advisory Committee to consider if carers of very vulnerable persons can be treated as the same cohort given these carers provide full-time care (details supplied); and if he will make a statement on the matter. [8381/21]

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Written answers

I propose to take Questions Nos. 737 and 784 together.

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 the Department of Health, endorsed by the National Public Health Emergency Team (NPHET), and approved by Government on 8 December 2020.

Vaccine allocation is a matter for the Department of Health 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 in the following order: 85 and older, 80-84, 75-79, and 70-74. Vaccination of this group will start in the week beginning the 15th of February.

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

The National Immunisation Advisory Committee continues to review all national and international data in order to inform the vaccine allocation process.

Family carers are a diverse group, therefore, each individual will be vaccinated in the group that is appropriate to them.

Health Services

Questions (738)

Neale Richmond

Question:

738. Deputy Neale Richmond asked the Minister for Health if he has considered introducing psychological and mental health supports for family carers to ease their burden; and if he will make a statement on the matter. [8248/21]

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.

Covid-19 Pandemic

Questions (739)

Róisín Shortall

Question:

739. Deputy Róisín Shortall asked the Minister for Health the percentage of incoming passengers who declared an essential reason for travel in each week in January 2021 to date; and if he will make a statement on the matter. [8249/21]

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Written answers

All passengers arriving to the State are required to complete a COVID-19 Passenger Locator form, there are limited exemptions from this requirement including international transport workers, diplomats and children under 16.

Table outlines the Percentage of Passengers who declared an essential reason for travel in January 2021

Week commencing

Percentage of Passengers who declared an essential reason for travel

4th January

36%

11th January

39%

18th January

43%

25th January

49%

Mental Health Services

Questions (740)

Neale Richmond

Question:

740. Deputy Neale Richmond asked the Minister for Health the steps he has taken to ensure that all those who need mental health supports have access to them in an affordable and timely manner; and if he will make a statement on the matter. [8250/21]

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.

Counselling Services

Questions (741)

Neale Richmond

Question:

741. Deputy Neale Richmond asked the Minister for Health when in-person counselling services will be permitted to resume; and if he will make a statement on the matter. [8252/21]

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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.

Counselling Services

Questions (742)

Neale Richmond

Question:

742. Deputy Neale Richmond asked the Minister for Health if he has considered declaring counselling services an essential service that can be conducted face-to-face with the necessary precautions taken; and if he will make a statement on the matter. [8253/21]

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Written answers

As you aware, Ireland is at level 5 of the Government's medium-term Strategy Resilience and Recovery 2020-2021: Plan for Living with COVID-19. This 5-level framework 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.

The public health measures recognise the need to reduce congregation and interactions between people to reduce the transmission of Covid-19. The number of people allowed to gather in different scenarios in the plan is based on a review of international practice and the judgment of public health experts. It seeks to balance the risks of different types of gatherings against the desire to allow normal activities to proceed in so far as possible. The measures in place for each level reflect the prevailing disease situation and recognise that we can and must prioritise some activities over others.

At level 5, all non-essential retail, and all non-essential services must remain closed. Information in relation to the current public health measures in relation to essential retail/essential services at level 5 is available at:- https://www.gov.ie/en/publication/2dc71-level-5/

The Deputy should note that therapy services provided by a member of a designated profession within the meaning of section 3 of the Health and Social Care Professionals Act 2005 (No. 27 of 2005) are considered essential under the regulations. The list of Human Health and Social Work Activities considered essential at Level 5 can be viewed at:- https://www.gov.ie/en/publication/c9158-essential-services/#human-health-and-social-work-activities

The Health Act 1947 (Section 31A - Temporary Restrictions) (COVID-19) (NO. 10) Regulations 2020 Regulation (S.I. 701 of 2020), sets out the relevant businesses or services under the current public health measures. Statutory Instruments related to the Covid-19 pandemic are available here: https://www.gov.ie/en/collection/1f150-view-statutory-instruments-related-to-the-covid-19-pandemic/

Vaccination Programme

Questions (743)

John Brady

Question:

743. Deputy John Brady asked the Minister for Health if his attention has been drawn to the concerns of parents as a result of the cancellation of the 4:1 booster and MMR as part of the primary school immunisation programme 2020-2021; when it is likely that the vaccination programme will recommence; and if he will make a statement on the matter. [8259/21]

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 (744, 745, 746)

Neale Richmond

Question:

744. Deputy Neale Richmond asked the Minister for Health if he has considered revisiting the renumeration for dentists who treat patients with medical cards to ensure that they are not at a loss for treating such patients; and if he will make a statement on the matter. [8260/21]

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Neale Richmond

Question:

745. Deputy Neale Richmond asked the Minister for Health the steps his Department is taking to encourage dentists to provide treatment under the medical card scheme; and if he will make a statement on the matter. [8261/21]

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Neale Richmond

Question:

746. Deputy Neale Richmond asked the Minister for Health if he has considered revisiting the terms of the medical card scheme for dentists to ensure that the scheme is beneficial to both patients and dentists; and if he will make a statement on the matter. [8262/21]

View answer

Written answers

I propose to take Questions Nos. 744 to 746, inclusive, together.

The Dental Treatment Services Scheme (DTSS) provides dental care, free of charge to medical card holders aged 16 and over. These services are provided by independent dental practitioners who have a contract with the HSE.

My Department has been engaging with dentists throughout the current Covid-19 pandemic. At the start of the pandemic, provision of dental services was restricted under legislation. Thanks to the efforts of the dental profession, working with the Health Protection Surveillance Centre, revised guidance was provided which allowed for the resumption of the safe provision of routine care in May 2020.

In that respect, I am advised by the HSE that services are now operating at close to ninety percent of pre-Covid levels which is a significant achievement on everyone’s part.

I met with representatives of the dental profession towards the end of last year when I had an opportunity to hear first-hand the challenges which they face under Covid, and the enormous efforts of their members in continuing to provide services in the current environment.

I accept that the profession has concerns about the current contract, which dates back to the nineties, and that that one of those concerns relates to the fee structure under the Dental Treatment Services Scheme.

I want to ensure the sustainability and viability of that contract going forward and that all eligible persons can continue to receive the services that they deserve from their local dentists.

I have asked my officials and the HSE to bring forward proposals to address those immediate concerns. In the longer term, my commitment to the profession and to the public is for a fundamental review of the contract, in keeping with Smile agus Sláinte, the National Oral Health Policy.

Ophthalmology Services

Questions (747)

Joe Flaherty

Question:

747. Deputy Joe Flaherty asked the Minister for Health if he will consider putting in place a refund scheme for parents who have no option but to source eye testing for their children privately (details supplied). [8265/21]

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 (748)

Verona Murphy

Question:

748. Deputy Verona Murphy asked the Minister for Health the level of logistical and transport expertise his Department will engage with to ensure a prompt and well managed Covid-19 vaccine roll-out is guaranteed when vaccine supplies increase; and if he will make a statement on the matter. [8269/21]

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 (749, 750, 751)

Verona Murphy

Question:

749. Deputy Verona Murphy asked the Minister for Health if consideration has been given to a Covid-19 vaccination centre in New Ross, County Wexford; and if he will make a statement on the matter. [8270/21]

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Verona Murphy

Question:

750. Deputy Verona Murphy asked the Minister for Health if consideration has been given to a Covid-19 vaccination centre in Gorey, County Wexford; and if he will make a statement on the matter. [8271/21]

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Verona Murphy

Question:

751. Deputy Verona Murphy asked the Minister for Health if consideration has been given to a Covid-19 vaccination centre in south County Wexford; and if he will make a statement on the matter. [8272/21]

View answer

Written answers

I propose to take Questions Nos. 749 to 751, inclusive, together.

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 (752)

Verona Murphy

Question:

752. Deputy Verona Murphy asked the Minister for Health if front-line mental healthcare staff will be included in Covid-19 vaccine allocation plans for front-line healthcare workers; and if he will make a statement on the matter. [8273/21]

View answer

Written answers

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 (Group 3) to be vaccinated are those aged 70 and older in the following order: 85 and older, 80-84, 75-79, and 70-74. Vaccination of this group will begin this month.

Frontline healthcare workers (HCWs) in direct patient contact roles will be vaccinated in Group 2. This includes HCWs working in public, private, and voluntary settings. Other HCWs, not in direct patient contact, will be vaccinated in Group 4.

The HSE has published a document on the sequencing of COVID-19 vaccination of frontline healthcare workers, which provides more detail. It is available at the following link:

https://www.hse.ie/eng/services/news/newsfeatures/covid19-updates/covid-19-vaccine-materials/sequencing-of-covid-19-vaccination-of-frontline-healthcare-workers.pdf

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.

Medicinal Products

Questions (753, 896)

Louise O'Reilly

Question:

753. Deputy Louise O'Reilly asked the Minister for Health if a drug (details supplied) has been approved by the HSE; and if he will make a statement on the matter. [8278/21]

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Patricia Ryan

Question:

896. Deputy Patricia Ryan asked the Minister for Health the steps he will take to expedite funding for gene-silencing treatment for amyloidosis such as a particular drug or equivalent drugs; and if he will make a statement on the matter. [8701/21]

View answer

Written answers

I propose to take Questions Nos. 753 and 896 together.

The HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drugs schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.

In line with the 2013 Health Act and the national framework agreed with industry, a company must submit an application to the HSE to have a new medicine added to the reimbursement list.

Reimbursement is for licenced indications which have been granted market authorisation by the European Medicines Agency or the Health Products Regulatory Authority.

HSE decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds, on the advice of the National Centre for Pharmacoeconomics (NCPE).

The HSE has advised that it received an application in December 2018 for the reimbursement of Patisiran (Onpattro) for the treatment of hereditary transthyretin-mediated amyloidosis (hATTR amyloidosis) in adult patients with stage 1 or stage 2 polyneuropathy.

In January 2019, a full health technology assessment (HTA) with respect to this indication was commissioned by the HSE. This assessment was completed in February 2020, with the NCPE recommending that Patisiran not be considered for reimbursement unless cost-effectiveness could be improved relative to existing treatments.

The HTA report with respect to Patisiran was reviewed by the HSE Drugs Group, along with the outputs of commercial discussions with the applicant which took place in May 2020, and the patient group submission received during the HTA process. The HSE Drugs Group requested patient and clinician input via the Rare Diseases Technology Review Committee (RDTRC) to assist the group in making its recommendation to the HSE Executive Management Team (EMT) regarding reimbursement of Patisiran.

The RDTRC convened on 24 September and reviewed the clinical data previously submitted as part of the established pricing and reimbursement process. The Committee also heard from Consultants involved in the specialist management of patients with hATTR amyloidosis. The RDTRC continued its review of Patisiran at its subsequent meeting on 5 November which included patient input on the impact of hATTR amyloidosis.

Following these meetings, the Committee finalised a statement summarising the clinician and patient engagement on Patisiran which was received by the HSE on 26 November 2020.

The HSE has advised that it met with the applicant company in December 2020 and in early January 2021 for further discussions and deliberations on the pricing position.

At its January 2021 meeting, the HSE Drugs Group reviewed all the relevant documentation concerning the application, including information provided by the RDTRC. The HSE has advised that, having considered all of the criteria of which is obliged to take account, the HSE Drugs Group was unable to recommend in favour of reimbursement.

The decision-making authority in the HSE is the HSE EMT. The HSE EMT decides on the basis of all the demands with which it is faced (across all services) whether it can fund a new medicine, or new uses of an existing medicine, from the resources that have been provided to it in line with the Health (Pricing and Supply of Medical Goods) Act 2013.

The HSE has confirmed that, on 9th February, it issued notice to the applicant company of the proposed decision of the EMT not to support reimbursement of Patisiran.

Where the HSE EMT team has considered a recommendation of non-reimbursement from the HSE Drugs Group and is minded to accept such a recommendation, the HSE is legally required (in line with the 2013 Health Act) to set out in detail a notice of any proposed decision to an applicant company.

The HSE, where such circumstances apply, is also legally required to provide at least a 28-day period (from the formal written notice of proposal) to enable an applicant company to consider the proposal not to reimburse and to make representations to the HSE. The HSE is legally required to consider any such representations in advance of a formal decision.

I am further advised by the HSE that it received an application in August 2019 for the reimbursement of Inotersen (Tegsedi) for the treatment of stage 1 or stage 2 polyneuropathy in adult patients with hereditary transthyretin amyloidosis (hATTR).

On 26 August 2019, the HSE commissioned a rapid review with respect to this indication. Following receipt of a rapid review dossier, the NCPE advised the HSE on 7 October 2019 that a full HTA was required for this medicine to assess the clinical effectiveness and cost effectiveness of Inotersen compared with the current standard of care.

The HSE commissioned a full HTA on 9 October 2019 as per agreed processes. As of 11 February 2021, the applicant has not submitted a HTA dossier to the NCPE for assessment. A completed HTA is required to progress this application, as per the formal processes governing the pricing and reimbursement of medicines.

The applications for Patisiran and Inotersen remain under consideration in line with the 2013 Health Act.

Primary Care Services

Questions (754)

Louise O'Reilly

Question:

754. Deputy Louise O'Reilly asked the Minister for Health the number of staff employed directly and currently in post, excluding any persons on maternity or other leave, in the primary care service for north County Dublin by grade and area covered; the number who work directly with individuals under 18 years of age; and if he will make a statement on the matter. [8279/21]

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.

Child and Adolescent Mental Health Services

Questions (755)

Louise O'Reilly

Question:

755. Deputy Louise O'Reilly asked the Minister for Health if his attention has been drawn to the growing waiting list to access CAMHS from the north county and city of Dublin CAMHS service based in Swords; the number employed by grade and whole-time equivalent; and if he will make a statement on the matter. [8280/21]

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.

Child and Adolescent Mental Health Services

Questions (756)

Louise O'Reilly

Question:

756. Deputy Louise O'Reilly asked the Minister for Health if his attention has been drawn to the urgent need for additional staffing for the CAMHS service based in Swords, County Dublin; the details of the planned recruitment by grade; and if he will make a statement on the matter. [8281/21]

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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