Written Answers Nos. 833-854
833. Deputy Carol Nolan asked the Minister for Health if there is specific data available on the contribution that attendance at religious services and public worship has made to the R number with respect to Covid-19; if so, if he will make that data available; and if he will make a statement on the matter. [9704/21]
View answerR is estimated at the population level. Modelling the specific impact of attendance at religious services and public worship on the R number is not in the scope of the work of the Irish Epidemiological Modelling Advisory Group (IEMAG), a sub-group of NPHET. It is in theory possible to ‘model’ the effect of specific restrictions or policy changes on the overall reproduction number. However, in order to do so one must make a series of assumptions about the number of close contacts that occur in a setting, the number of close contacts that occur in the population as a whole, the relative risk that such close contacts lead to infection, and the effect of mitigating measures such as the use of PPE. Small changes in these assumptions lead to very different outcomes in terms of impact upon R. IEMAG is of the view that it is not feasible to provide reliable estimates of the impact on R of very specific interventions.
Technical notes on the approaches used to estimate effective reproduction number (Re) or time-dependent reproduction number (Rt) are published on the Department of Health website (https://www.gov.ie/en/publication/dc5711-irish-epidemiology-modelling-advisory-group-to-nphet-technical-notes/). The approaches used are in line with best practice and associated references are available in the above mentioned published technical notes.
834. Deputy Alan Kelly asked the Minister for Health the funding and or grants for building, plant or equipment provided to Mayo University Hospital since 2015, in tabular form. [9720/21]
View answerAs the Health Service Executive is responsible for the delivery of public healthcare infrastructure projects and management of healthcare equipment, I have asked the HSE to respond to you directly in relation to this matter.
835. Deputy Alan Kelly asked the Minister for Health the number of persons awaiting plastic surgery in Connolly Hospital, Blanchardstown. [9721/21]
View answerIt 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 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.
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 regard to the information requested by the Deputy, the latest National Treatment Purchase Fund (NTPF) figures show that there are 117 patients on plastic surgery waiting lists at Connolly Hospital. Due to Statistical Disclosure Control (SDC) reasons, to protect patient identities, we cannot identify whether they are on inpatient & daycase (IPDC) or outpatient waiting lists.
836. Deputy Alan Kelly asked the Minister for Health the primary care centres in community healthcare organisation, CHO, 9; and the services provided within each in tabular form. [9722/21]
View answerAs the HSE has responsibility for the provision, along with the maintenance and operation of Primary Care Centres and other Primary Care facilities, the Executive has been asked to reply directly to the Deputy.
837. Deputy Alan Kelly asked the Minister for Health the number of vacancies by job title in the early pregnancy assessment unit at Our Lady of Lourdes Hospital, Drogheda. [9723/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
838. Deputy Alan Kelly asked the Minister for Health the number of adult mental health respite care facilities in community healthcare organisation, CHO, 1 for persons living in County Cavan. [9724/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
839. Deputy Alan Kelly asked the Minister for Health if alongside birth centres pursuant to the National Maternity Strategy have been rolled out. [9725/21]
View answerImplementation of the National Maternity Strategy - Creating A Better Future Together 2016 - 2026 - is being led by the HSE National Women & Infants Health Programme. I have therefore asked the HSE to reply to you directly as soon as possible.
840. Deputy Alan Kelly asked the Minister for Health if funding will be provided for the recruitment of an additional consultant neurosurgeon with a special interest in paediatric neurosurgery at Beaumont Hospital, Dublin 9. [9726/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly as soon as possible.
841. Deputy Alan Kelly asked the Minister for Health the estimated full-year cost in 2021 of recruiting five additional full-time permanent audiologists for community healthcare organisation, CHO, 7. [9727/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy, as soon as possible.
842. Deputy Bernard J. Durkan asked the Minister for Health when an appropriate residential place with treatment will be offered in the case of a person (details supplied); and if he will make a statement on the matter. [9728/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
843. Deputy Richard Boyd Barrett asked the Minister for Health the options available for front-line workers with primary school age children in relation to childcare; and if he will make a statement on the matter. [9729/21]
View answerIn line with DPERs Guidance on HR matters during Covid-19 document which applies equally to all Civil and Public Sector employers and employees (https://www.gov.ie/en/news/092fff-update-on-working-arrangements-and-leave-associated-with-covid-19-fo/), where school closures are in effect across the country due to COVID-19 restrictions, childcare services, including childminders, and other existing childcare arrangements remain open and can continue for children of essential workers and vulnerable children including those employed in the health sector.
In addition, a household of an essential worker, without an existing childcare arrangement, can form a bubble with another household for the purpose of providing childcare.
Where these options are exhausted, employers and employees may, alternative arrangements for flexible working, including working from home and/or working adjusted hours, staggered hours, weekend work etc. should be utilized where possible.
Employees may also choose to utilise existing leave allowances including parental leave and annual leave for this purpose.
These provisions exist across the public service and are not restricted to the public health sector.
844. Deputy Catherine Connolly asked the Minister for Health when matters raised in correspondence by a person (details supplied) on 6 July 2020 will receive a response; and if he will make a statement on the matter. [9730/21]
View answerThe correspondence referred to is with my Department. I will reply to the correspondent in due course.
845. Deputy Michael Ring asked the Minister for Health if a certain cohort (details supplied) can receive the Covid-19 vaccination without delay in view of the impact the lack of vaccination will have on the persons they work with. [9735/21]
View answerThe 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 started 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 evidence will be kept under review and the allocation groups may be updated, where necessary, in light of new evidence.
846. Deputy Francis Noel Duffy asked the Minister for Health if the fair deal scheme has been reformed to incentivise those in long-term residential care and their families to rent out vacant properties; and if he will make a statement on the matter. [9739/21]
View answerThe Nursing Home Support Scheme (NHSS), commonly referred to as 'Fair Deal', is a system of financial support for people who require long-term residential care. The primary legislation underpinning the NHSS is the Nursing Home Support Scheme Act 2009. Participants in the NHSS contribute to the cost of their care according to their means while the State pays the balance of the cost. The Scheme aims to ensure that long-term nursing home care is accessible and affordable for everyone and that people are cared for in the most appropriate settings.
Under the NHSS, rental income is considered as ‘income’ for the purpose of a financial assessment of means and is currently assessed at 80% less any allowable deductions. Assets are assessed at 7.5% of their annual value for the duration of an individual participant’s time on the scheme, with the exception of the principal private residence, which is only assessed for the first three years.
The current Programme for Government, Our Shared Future, commits to “reforming the Fair Deal scheme to incentivise the renting out of vacant properties”. My Department is currently engaging with the Department of Housing, Local Government and Heritage on how to take this forward.
However, there are significant complexities in relation to any changes being made to the NHSS, particularly with regard to ensuring the ongoing fair, equitable, and sustainable operation of the scheme. My Department must also be sure that any change delivers a genuine impact and offers value for money. On this basis, all competing interests and relevant issues must be fully considered.
My department is liaising closely with the Department of Housing, Local Government and Heritage to develop an evidence base around the issue and consider potential policy measures.
847. Deputy Duncan Smith asked the Minister for Health the status of the plans his Department and the HSE have with regard to licensing the drug dupilumab for use by patients with severe eczema as of February 2021 given the HSE drugs group met on 12 January 2021; and if he will make a statement on the matter. [9741/21]
View answer870. Deputy Sorca Clarke asked the Minister for Health if dupilumab has been approved for use in patients with severe eczema. [9850/21]
View answerI propose to take Questions Nos. 847 and 870 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 licensed 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 received pricing and reimbursement applications for two indications of Dupilumab (Dupixent):
- For the treatment of moderate-to-severe atopic dermatitis in adult patients who are candidates for systemic therapy.
- For the treatment of moderate-to-severe atopic dermatitis in adolescents 12 years and older who are candidates for systemic therapy.
The HSE received an application for pricing / reimbursement of Dupilumab in November 2017 from the manufacturer for the treatment of moderate-to-severe atopic dermatitis in adult patients who are candidates for systemic therapy. The HSE commissioned a full HTA on 29 November 2017 as per agreed processes. This assessment was completed on 12 December 2019 with the NCPE recommending that Dupilumab be considered for reimbursement if cost-effectiveness could be improved relative to existing treatments.
Subsequently, the HSE received an application for the pricing / reimbursement of Dupilumab on 13 December 2019 for the treatment of moderate-to-severe atopic dermatitis in adolescents 12 years and older who are candidates for systemic therapy.
The HSE commissioned the rapid review process on 17 December 2019. Following receipt of a rapid review dossier, the NCPE advised the HSE on 17 January 2020 that a HTA was not recommended and that Dupilumab not be considered for reimbursement for this indication at the submitted price.
The HSE engaged in commercial negotiations with the company in February 2020 regarding both the adult and adolescent populations.
The HSE Drugs Group is the national committee which the HSE has in place to make recommendations on the pricing and reimbursement of medicines. The membership of the HSE Drugs Group includes public interest members and clinicians.
The final decision-making authority in the HSE is the HSE Executive Management Team (EMT). The HSE EMT decides on the basis of all the demands it is faced with (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 final HTA report and NCPE recommendations concerning Dupilumab were reviewed by the HSE Drugs Group, along with the outputs of the commercial negotiations, and the patient group submission received during the HTA process. The HSE Drugs Group considered all the evidence and gave a recommendation to the HSE EMT not to support reimbursement of Dupilumab for the treatment of moderate-to-severe atopic dermatitis in both adults and adolescents 12 years and older who are candidates for systemic therapy.
The HSE has confirmed that the applicant company was issued with notice of the proposed decision of the HSE EMT not to support reimbursement on 21 August 2020. On 18 September 2020, the applicant company submitted representations with respect to these applications.
The HSE reviewed these representations, as is required in such circumstances under the 2013 Health Act, and engaged in a meeting in November 2020 with the applicant company to discuss the submission.
The HSE has advised that the HSE Drugs Group, having reviewed the above representations at their January 2021 meeting, supported reimbursement of Dupilumab for the following defined subgroup of the full licensed indication: moderate-to-severe atopic dermatitis in refractory adults and adolescents 12 years and older for whom immunosuppressant treatment has failed, or is not tolerated or is contraindicated.
The HSE has further advised that the HSE EMT received this recommendation and supported the reimbursement of Dupilumab under High Tech Arrangements, subject to the implementation of a managed access programme and the restriction of reimbursement to the defined subgroup which was recommended by the HSE Drugs Group.
Under the 2013 Health Act, the HSE has statutory responsibility for the administration of the community drug schemes. Therefore, the matter has been referred to the HSE for direct reply to the Deputies in relation to the proposed managed access programme and the formalising of a final reimbursement decision.
848. Deputy Pa Daly asked the Minister for Health the breakdown of the Covid-19 vaccine refusal rates amongst healthcare workers in acute hospital groups in tabular form. [9745/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
849. Deputy Willie O'Dea asked the Minister for Health if a person (details supplied) will be offered the vaccine for Covid-19; and if he will make a statement on the matter. [9748/21]
View answerThe 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 started 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 evidence will be kept under review and the allocation groups may be updated, where necessary, in light of new evidence.
850. Deputy Alan Kelly asked the Minister for Health the reason phlebotomists cannot be recruited as vaccinators; if he will amend Statutory Instrument No. 698 of 2020 to include this class of healthcare worker; the reason for the exclusion; if his attention has been drawn to the fact that phlebotomists are being recruited in the UK as vaccinators; if he will now include phlebotomists as a category eligible for recruitment to the mass vaccination drive; and if he will make a statement on the matter. [9753/21]
View answerThe HSE are building and deploying its workforce in order to be prepared for the requirements associated with rolling out the COVID-19 vaccine programme.
GPs, Pharmacists, doctors, nurses, paramedics, and many healthcare professionals, will have a role to play in the vaccination programme.
The vaccine rollout is being conducted on a 7-day week basis and to date, more than 7,400 staff have received training to operate as vaccinators. To support the expanded immunisation programme the HSE launched a vaccinator recruitment campaign last week.
It is not intended that phlebotomists will be called upon to participate as vaccinators in the programme at this time.
851. Deputy Seán Canney asked the Minister for Health if he will consider increasing the number of guests from six to 25 for weddings as pertained during previous lockdowns; and if he will make a statement on the matter. [9759/21]
View answerAs the Deputy is aware, the public health restrictions at level 5 of the Government's Framework Resilience and Recovery 2020-2021: Plan for Living with COVID-19 will remain in place until 5th April 2021, when a further review will be conducted. The Framework continues to provide an appropriate mechanism to guide decision-making, and it will continue to be supplemented by more detailed sectoral guidance in relation to measures that apply at each level of the Framework.
On 23 February, 2021, the Government published COVID-19 Resilience & Recovery 2021: The Path Ahead which sets out how in-school education and childcare services will be reinstated in a phased manner from 1 March, with staggered return throughout March to be concluded after the Easter break on 12 April. Information on the revised plan is available here – https://www.gov.ie/en/publication/c4876-covid-19-resilience-and-recovery-2021-the-path-ahead/?referrer=http://www.gov.ie/ThePathAhead/
At Level 5, 6 guests may attend the wedding and wedding ceremony irrespective of venue. This does not include the persons getting married or persons attending in a professional capacity. The various limits at all levels in the Government's Plan are all designed to reduce the number of households mixing with each other and cut down the virus’s chances of spreading into more homes. 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.
As I'm sure the Deputy can appreciate, COVID-19 spreads when individuals and groups come into close contact with one another, enabling the virus to move from one person to another. COVID-19 is infectious in a person with no symptoms, or for the period of time before they develop symptoms. In certain settings, such as weddings, higher noise levels due to music, can force people into close proximity, requiring them to raise their voices or shout to communicate thus increasing the risk of spreading the virus to others.
It is not possible to say what public health measures will be in place in the future. The public health advice relating to Covid-19 is kept under continuing review by the National Public Health Emergency Team (NPHET), by my Department and by the Government . The measures in place and the public health advice have been adapted to the changing circumstances and this will continue to be the case for the foreseeable future.
Details of the public health measures currently in place for weddings can be found at:- https://www.gov.ie/en/publication/2dc71-level-5/#weddings
You may also wish to note that Fáilte Ireland has provided guidelines for the hospitality industry which includes guidance on weddings and is available at: - https://failtecdn.azureedge.net/failteireland/Guidelines-for-Re-opening-Hotels-and-Guesthouses.pdf
852. Deputy Charles Flanagan asked the Minister for Health further to Parliamentary Question No. 832 of 27 January 2021, when a reply will issue from the HSE; and if he will make a statement on the matter. [9760/21]
View answerThe Programme for Government, Our Shared Future, recognises the need to improve services for both children and adults with disabilities through better implementation and by working together across Government in a better way.
The Government commits to prioritising early diagnosis and access to services for children and ensuring that the most effective interventions are provided for each child, to guarantee the best outcomes.
As this is a service matter I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
853. Deputy Sorca Clarke asked the Minister for Health the number of full-time pulmonary function physiotherapists working in Mullingar Regional Hospital in 2019, 2020 and to date in 2021, in tabular form. [9769/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
854. Deputy Sorca Clarke asked the Minister for Health the number of full-time consultants in paediatric audio vestibular medicine at CHI, Crumlin. [9770/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
