Written Answers Nos. 285-300
285. Deputy Thomas Pringle asked the Minister for Health if IVF treatment will be commencing for persons on a public health basis; when treatment will commence; and if he will make a statement on the matter. [10688/21]
View answerAs the Deputy will be aware, a commitment to introduce the model of care for infertility, which was developed by officials in my Department in conjunction with the HSE’s National Women & Infants Health Programme, is included in the Programme for Government, “Our Shared Future”. This model of care will ensure that infertility issues will be addressed through the public health system at the lowest level of clinical intervention necessary. It will comprise three stages, starting in primary care (i.e., GPs) and extending into secondary care (i.e., Regional Fertility Hubs) and then, where necessary, tertiary care (i.e., IVF and other advanced assisted human reproduction (AHR) treatments). Structured referral pathways will be put in place and patients will be referred onwards for further investigations or treatment as required and as clinically appropriate. It is intended that, in line with available resources, this model of care for infertility will be rolled out on a phased basis over the course of the coming years.
Phase One of the roll-out of the model of care has commenced and involves the establishment, at secondary care level, of Regional Fertility Hubs in maternity networks. which will facilitate the management of a significant proportion of patients presenting with infertility issues.
Phase Two of the roll-out will see the introduction of tertiary infertility services, including IVF, in the public health system. Phase Two will not commence until such time as infertility services at secondary level have been developed across the country, required resources have been allocated, and the AHR legislation is commenced. Drafting of the AHR legislation is ongoing, in conjunction with the Office of the Attorney General.
Overall, the implementation of the model of care will help to ensure the provision of safe, effective and accessible infertility services at all levels of the public health system as part of the full range of services available in obstetrics and gynaecology.
It should be noted that while AHR treatment is not currently funded by the Irish public health service, a defined list of fertility medicines needed for fertility treatment is covered under the High Tech Arrangements administered by the HSE. Medicines covered by the High Tech Arrangements must be prescribed by a consultant/specialist and authorised for supply to the client’s nominated community pharmacy by the High Tech Hub managed by the Primary Care Reimbursement Service. The cost of the medicines is then covered, as appropriate, under the client’s eligibility, i.e., Medical Card or Drugs Payment Scheme. Given the costs associated with certain fertility medicines, I am aware that these schemes can have a material impact on the total cost of AHR treatment for individuals who avail of them.
In addition, there is other support available in that patients who access IVF treatment privately may claim tax relief on the costs involved under the tax relief for medical expenses scheme.
286. Deputy Brian Stanley asked the Minister for Health if persons on dialysis and who have other serious health problems can be prioritised for Covid-19 vaccinations. [10697/21]
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 began in February.
On 23 February, I announced an update to Ireland’s COVID-19 Vaccine Allocation Strategy.
In comprising the initial Vaccine Allocation Strategy, the NIAC listed several conditions associated with increased risk of severe disease and death. In the intervening period, national and international evidence has become available which has enabled a more detailed analysis of underlying conditions that may increase the risk of developing severe disease or death.
The NIAC has now been able to more comprehensively identify those medical conditions and to distinguish between those which place a person at very high or high risk of severe disease if they contract the virus. Medical conditions and the magnitude of the risk they pose will continue to be monitored and periodically reviewed.
The NIAC continues to monitor data around this disease and indeed emerging data on effectiveness of vaccines on a rolling basis.
Further details are available at the following link: https://www.gov.ie/en/press-release/b44b2-minister-donnelly-announces-update-to-vaccine-allocation-strategy/
287. Deputy Richard O'Donoghue asked the Minister for Health his position on the halting of primary medical certificate assessments by the HSE; and if he will make a statement on the matter. [10698/21]
View answer288. Deputy Richard O'Donoghue asked the Minister for Health his position on alternative travel arrangements for patients awaiting a primary medical assessment; if funding will be allocated to patients for transport to medical appointments; and if he will make a statement on the matter. [10699/21]
View answerI propose to take Questions Nos. 287 and 288 together.
The Disabled Drivers and Disabled Passengers (Tax Concessions) Scheme is underpinned by statute and comes under the remit of the Department of Finance and the Revenue Commissioners.
The extent of the involvement of Health Service Executive (HSE) personnel in the Scheme relates to making a professional clinical determination as to whether an individual applicant meets the specified medical criteria for a Primary Medical Certificate, which is a requirement for the Scheme. This determination is undertaken by Community Medical Doctors for the relevant HSE Community Health Organisation on behalf of the Department of Finance and the Revenue Commissioners.
The Deputy may be aware that following a Supreme Court decision of June 2020, the assessment process for Primary Medical Certificates was suspended at the request of the Minister for Finance, Paschal Donohoe T.D.. Following the approval of the Finance Act 2020 which provides for the medical criteria in primary legislation, the Minister for Health, Stephen Donnelly, T.D., issued an instruction to the Chief Executive Officer of the HSE to the effect that Primary Medical Certificate assessments can recommence with effect from 1st January, 2021.
In the context of the national effort to suppress and manage the impact of COVID, the ability to hold assessments is impacted by, among other things, the public health restrictions in place and the role of the HSE Medical Officers in the roll out of the COVID vaccination programme. The HSE has confirmed that the Community Medical Doctors and their teams are predominately deployed to the COVID vaccination rollout in residential care facilities and other health care settings.
I have been informed that the HSE is considering the matter of Primary Medical Certificate assessments in the context of their revision of the HSE Recovery and Restoration Plan, taking into account the pressures and challenges to the health services presented by COVID.
As the issue raised by the Deputy relating to transport to medical appointments is a service matter, I have arranged to have the question referred to the HSE for consideration and direct reply to the Deputy.
289. Deputy Michael Healy-Rae asked the Minister for Health if registration fees will be waived for the members of an association (details supplied); and if he will make a statement on the matter. [10700/21]
View answerThe issue of waiving of fees for nurses, midwives and other health and social care registrants was raised early in 2020 in the context of removing any barrier to encouraging previous registrants, e.g. retired professionals, to return to the workforce to help with the response to COVID-19. At that time, emergency legislation was introduced which amended all the regulatory acts to provide for a COVID-19 specific register to which no fees would be attached. The Act provided that the COVID-19 registration would end on 31 July 2020, but that this could be extended by means of Ministerial order. Orders were made in July, 2020 extending the temporary registrations to 31 December 2020, and again in December further extending to 30 June 2021 the temporary registration provisions relating to medical practitioners, pharmacists and CORU registrants.
Given that nursing and midwifery registration is based on a calendar year, an Order was not needed in July extending these to end December 2020, but rather the Irish Nursing and Midwifery Board (NMBI) was able to deal with such registrations ( including any new applications ) under its existing legislation. This continues to be the position and I can confirm that retired nurses who wish to assist with the COVID-19 pandemic response, including the vaccination programme, can avail of temporary restoration to the NMBI register free of charge. The NMBI has informed my Department that it is currently working with the HSE and other employers to facilitate speedy restoration in these cases. As part of this, the NMBI is currently updating the registration system MyNMBI so that, from Monday next, 1 March 2021, fees will be waived automatically upon restoration - https://www.nmbi.ie/Registration/Restoration. Those wishing to restore on MyNMBI and who need support with the process can contact the NMBI directly at IEReg@nmbi.ie.
In addition, the NMBI is also now making arrangements to refund fees paid by some registrants who may not have been aware of the availability of free temporary restoration for purposes of assisting with the COVID-19 pandemic response.
I very much welcome the offer of the association referred to by the Deputy and its members, to return to the NMBI register to assist with the response to the COVID-19 pandemic. To expedite this the NMBI has contacted the association in recent days.
Finally, to clarify the general position applying to restoration to the Register. It is open to a nurse or midwife to apply at any time to be removed from the Register of the NMBI, for example on retirement. This is categorised as a voluntary removal and such registrants who later wish to be restored need only to pay the annual renewal fee of €100, which is the same amount as all other current registrants. Those registrants who have been removed from the register following non-payment of the renewal fee of €100, and who later wish to be restored, incur an additional administration charge of €250 in addition to the annual fee of €100.
290. Deputy Michael Healy-Rae asked the Minister for Health when a person (details supplied) who requested glasses will receive an appointment; and if he will make a statement on the matter. [10702/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
291. Deputy Peadar Tóibín asked the Minister for Health if the HSE will facilitate a community-based health organisation (details supplied) in the CHO8 area. [10707/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
292. Deputy Patrick Costello asked the Minister for Health if his Department or the HSE have a policy on which the Covid-19 vaccine is administered to persons, for example, which takes into account existing medical conditions such as gastrointestinal side effects. [10731/21]
View answerThe revised Vaccine Allocation Strategy developed by the National Immunisation Advisory Committee, in conjunction with the Department of Health, and endorsed by the National Public Health Emergency Team, was approved by Government on the 23rd of February.
In the initial vaccine allocation strategy, the NIAC listed several medical conditions associated with an increased risk of serious illness and death. In the interim, additional national and international evidence has become available which enables a more detailed examination of specific underlying medical conditions which increase the risk of developing severe disease or dying following infection with SARS-CoV-2.
This has allowed NIAC to sub-divide those with specific medical conditions into those at very high-risk and those at high risk of serious disease and death. Medical conditions and magnitude of risk from each of these underlying conditions will be monitored and periodically reviewed.
The revised vaccine allocation strategy can be found at: https://www.gov.ie/en/press-release/b44b2-minister-donnelly-announces-update-to-vaccine-allocation-strategy/
293. Deputy Paul Kehoe asked the Minister for Health if guidance will be provided on the process for a child and their family returning to Ireland after attending an appointment in Great Ormond Street Hospital, London (details supplied); and if he will make a statement on the matter. [10735/21]
View answerUnder SI No. 44/2021, passengers arriving into Ireland from overseas, with limited exemptions, are required to have evidence of a negative pre-departure RT-PCR test. The test is required to have been taken within 72 hours of travel to Ireland, however it is not required to have been taken in the country of departure. SI No. 44/2021 also imposes a mandatory home quarantine requirement on arriving passengers.
An exemption from mandatory testing and quarantine requirements is in place for persons who travel to the State is for unavoidable, imperative and time sensitive medical reasons.
Travellers are also required to quarantine for 14 days at the address given on their Passenger Locator Form., with limited exceptions. A second ‘non-detected’ PCR test result, taken no less than 5 days after arrival, can end the quarantine period. Arrivals from Category 2 countries must complete the full 14 days of quarantine - regardless of test results during the period.
294. Deputy Emer Higgins asked the Minister for Health if he will facilitate older persons living within 10 km of Citywest to receive their vaccine there, rather than in the Helix if they cannot be administered to them in their local general practitioner surgery. [10750/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
295. Deputy Aodhán Ó Ríordáin asked the Minister for Health the way and by whom the decision was made to not make a vaccine (details supplied) available to persons over 70 years of age; if a revision of same is planned in view of the WHO statement that the vaccine is suitable for use in this age group; and if he or the relevant body will make the vaccine available to persons over 70 years of age on a voluntary basis so that any person in this cohort who wishes to avail of the vaccine can do so. [10759/21]
View answerCovid-19 vaccines can only be approved and used if they comply with all the requirements of quality, safety and efficacy set out in the EU pharmaceutical legislation. Any authorised vaccine will be subject to ongoing monitoring in Ireland by the Health Product Regulatory Authority (HPRA).
Following the recommendation for use of vaccines against COVID-19 by the European Medicines Agency (EMA) and authorisation for use by the European Commission, the National Immunisation Advisory Committee (NIAC) develops guidance for their use in Ireland which is contained in the Immunisation Guidelines for Ireland. These guidelines are continuously updated and includes guidance on all new vaccines as they are approved for use in Ireland.
The National Immunisation Advisory Committee (NIAC) has recommended that, in line with the approvals granted by the European Medicines Agency (EMA), all currently authorised COVID-19 vaccines can be used in adults of all ages, including those aged 70 years and older.
NIAC has also recommended that mRNA vaccines (Pfizer/BioNTech and Moderna) should be used for the over 70’s, where practicable and timely.
Preferential selection of an mRNA vaccine should not result in a vaccine delay of more than 3 weeks, as any benefit of using a higher efficacy vaccine may be lost.
The expert advice recognised that currently there is limited data on the AstraZeneca vaccine in relation to older age groups. Those aged over 70 are a key priority group for protection because of their greater risk of severe illness, hospitalisation and death from COVID-19. A number of other EU countries have made similar decisions with regard to the provision of mRNA vaccines to older people.
296. Deputy Colm Burke asked the Minister for Health the number of staff working in the HSE in Cork city and county per year from 2011 to 2021, in tabular form; and if he will make a statement on the matter. [10761/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy, as soon as possible.
297. Deputy Colm Burke asked the Minister for Health if he will prioritise informal carers in the vaccination schedule as they provide an essential service for vulnerable persons; and if he will make a statement on the matter. [10762/21]
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 began in February.
On the 23rd of February, I announced an update to Ireland’s COVID-19 Vaccine Allocation Strategy.
In comprising the initial Vaccine Allocation Strategy, the NIAC listed several conditions associated with increased risk of severe disease and death. In the intervening period, national and international evidence has become available which has enabled a more detailed analysis of underlying conditions that may increase the risk of developing severe disease or death.
The NIAC has now been able to more comprehensively identify those medical conditions and to distinguish between those which place a person at very high or high risk of severe disease if they contract the virus. Medical conditions and the magnitude of the risk they pose will continue to be monitored and periodically reviewed.
The NIAC continues to monitor data around this disease and indeed emerging data on effectiveness of vaccines on a rolling basis.
Further details are available at the following link: https://www.gov.ie/en/press-release/b44b2-minister-donnelly-announces-update-to-vaccine-allocation-strategy/
Family carers are a diverse group, therefore, each individual will be vaccinated in the group that is appropriate to them.
298. Deputy Colm Burke asked the Minister for Health the amount spent on public hospitals in Cork city and county per year from 2011 to 2021, in tabular form; and if he will make a statement on the matter. [10768/21]
View answerThe HSE's 2020 year-end expenditure position is currently being finalised. Please see below the amount of public expenditure relating to acute hospitals in Cork city and county per year from 2011 to 2019.
299. Deputy Róisín Shortall asked the Minister for Health further to Parliamentary Question No. 844 of 17 February 2021, if private providers of Covid-19 antigen tests are required to report their results to the Chief Medical Officer given that the tests do not go to a laboratory; the way these antigen tests are accounted for in daily case figures; and if he will make a statement on the matter. [10776/21]
View answerAs I indicated in response to Parliamentary Question 844 of 17 February 2021, under the Infectious Disease Regulations (S.I. No. 53/2020 - Infectious Diseases (Amendment) Regulations 2020 which amended the Infectious Diseases Regulations 1981 (S.I. No. 390 of 1981), all medical practitioners, including clinical directors of diagnostic laboratories, are required to notify the Medical Officer of Health / Director of Public Health of certain diseases, including COVID-19.
The Medical Officer of Health also reports such cases onwards to the Health Protection Surveillance Centre (HPSC). This is to ensure that test results are reported to relevant stakeholders for monitoring and surveillance purposes and to investigate cases, thus preventing spread of infection and further cases. This requirement also applies to all private testing services who are, therefore, legally obliged to report positive Covid-19 case to the relevant authorities.
Persons who test positive from an antigen test from a private company will not be reported to the HSE. These are unvalidated tests taken outside of the national testing strategy or without appropriate clinical governance and operational arrangements. In my answer to Parliamentary Questions 682, 683 and 684 of the same date from the same Deputy, I drew attention to the factual, up to date and accessible public facing information on private testing published on the HSE website https://www2.hse.ie/conditions/coronavirus/testing/private-testing-for-covid-19.html. The HSE advises that if you test positive in this case, you should self-isolate and call your GP. They will arrange for you to get a free PCR test within the public testing system.
The NPHET (National Public Health Emergency Team) considers the use of Antigen Detection Tests (ADTs) on an ongoing basis and has endorsed recommendations on the use of ADTs that have been validated as a supplement to PCR testing in certain situations, and particularly when the availability of PCR tests may be limited.
The HSE is currently putting in place deployment options for the use of ADTs for specific indications in the acute hospital setting and as part of the response to outbreaks in the community setting in symptomatic vulnerable populations and their close contacts, supported by appropriate clinical governance and operational arrangements. This includes updating the case definition for SARS-CoV-2 to accept notification of positive results from ADTs undertaken in the public health system and reporting of such cases to the COVID Care tracker and to the Computerised Infectious Disease Reporting (CIDR) information system developed to manage the surveillance and control of infectious diseases in Ireland.
300. Deputy Róisín Shortall asked the Minister for Health if there was political involvement in the decision to purchase ventilators from a company (details supplied); if he signed off on the deal at the time; and the due diligence carried out on the company in question prior to awarding a contract. [10780/21]
View answerThe then-Minister for Health, Simon Harris T.D., had no involvement in the procurement of ventilators from the company in question. As procurement of medical equipment is a matter for the Health Service Executive (HSE), I have requested that the HSE respond to the Deputy directly on the latter part of the question.
