Written Answers Nos. 957-981
957. Deputy Matt Carthy asked the Minister for Health the number of general practitioner practices per county that have yet to receive the necessary allocation of vaccines to cover the first vaccination of their patients over 85 years of age as of 4 March 2021; and if he will make a statement on the matter. [13435/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
958. Deputy Pádraig O'Sullivan asked the Minister for Health if his attention has been drawn to the circumstances of a family (details supplied); if consideration will be given to this request; and if he will make a statement on the matter. [13438/21]
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.
Vaccination of those aged 70 and older (in the following order: 85 and older, 80-84, 75-79, and 70-74) 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/
The ongoing review process will continue to look at the other priority groups yet to be vaccinated, along with the competing needs of those working or living in high-risk situations, carers who deliver essential services to highly dependent individuals in the home setting, and those who are socially vulnerable/disadvantaged.
959. Deputy Pádraig O'Sullivan asked the Minister for Health if he will provide further information on a case (details supplied); and if he will make a statement on the matter. [13439/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
960. Deputy Christopher O'Sullivan asked the Minister for Health if he will conduct a review into the current assessment of needs standard operating procedure; the role parents will take in this review; and if he will make a statement on the matter. [13440/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
961. Deputy Paul Murphy asked the Minister for Health if he will review the policy of allocating only certain types of vaccines (details supplied) for the over 70s in view of the recent decisions in this respect by the French and German Governments. [13443/21]
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.
The NIAC continues to monitor data around this disease and indeed emerging data on effectiveness of vaccines on a rolling basis.
962. Deputy Rose Conway-Walsh asked the Minister for Health the status of the inquiry into the historical licensing of sodium valproate which was announced in November 2020; if the terms of reference have been agreed; and if he will make a statement on the matter. [13444/21]
View answerDetails of the proposed inquiry into the historical licensing and use of sodium valproate in Ireland are being considered by officials within the Department of Health.
963. Deputy Rose Conway-Walsh asked the Minister for Health if he plans to establish a valproate stakeholder group consisting of State bodies, representative and patient groups to improve the co-ordination of risk minimisation measures associated with the ongoing use of sodium valproate in women of child-bearing age; and if he will make a statement on the matter. [13445/21]
View answerThe establishment of a valproate stakeholder group as described by the Deputy is being considered by officials as part of the Department's overall response to issues relating to sodium valproate.
964. Deputy Rose Conway-Walsh asked the Minister for Health the status of the establishment of the community operations programme for families of children affected by sodium valproate; if funding is currently in place to ensure that the programme is made fully operational; and if he will make a statement on the matter. [13446/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
965. Deputy Matt Carthy asked the Minister for Health if he will ensure that pregnant women can be joined by their partner during prenatal scans and childbirth; the current situation that applies in each maternity hospital; and if he will make a statement on the matter. [13448/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
966. Deputy Rose Conway-Walsh asked the Minister for Health the details of funding options available to persons requiring fertility treatment; if such treatment is not available on the public system under the medical card; and if he will make a statement on the matter. [13459/21]
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. As such, no decisions have been made on the eligibility criteria which will need to be satisfied to a enable a person to access advanced AHR treatments through the public system.
An important consideration in developing the model of care and in determining the parameters that would frame it, was its interplay with the broader AHR regulatory framework and 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.
967. Deputy John McGuinness asked the Minister for Health further to Parliamentary Question Nos. 298 and 900 of 24 February 2021 and the reply issued by the HSE on 2 March 2021, the refurbishment work undertaken at the Carlow ambulance service base by the HSE; the breakdown of the costs; and if information (details supplied) in relation to the project will be provided. [13460/21]
View answerAs the Health Service Executive is responsible for the delivery of public healthcare infrastructure projects, I have asked the HSE to respond to the Deputy directly in relation to this matter.
968. Deputy Jennifer Carroll MacNeill asked the Minister for Health the reason the semaglutide (details supplied) injection was removed from the drug payment scheme for persons with polycystic ovary syndrome; if it will be included on the scheme for such persons; and if he will make a statement on the matter. [13463/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
969. Deputy Róisín Shortall asked the Minister for Health if he has given consideration to matters raised in correspondence (details supplied) regarding Covid-19 and the Health (Regulation of Termination of Pregnancy) Act 2018; his response to same; and if he will make a statement on the matter. [13474/21]
View answerIt would not be appropriate for me, as Minister for Health, to discuss the details of any individual case.
As the Deputy will be aware, section 11 of the Health (Regulation of Termination of Pregnancy) Act 2018 sets out the law on access to termination of pregnancy in cases where there is a condition present affecting the foetus that is likely to lead to the death of the foetus before or within 28 days of birth. It requires the involvement of two medical practitioners, one of whom must be an obstetrician and the other a medical practitioner of a relevant specialty. Both must examine the pregnant woman and both must certify their reasonable opinion, formed in good faith that the termination of pregnancy can be carried out. The termination of pregnancy must then be carried out by the certifying obstetrician, or in cases where the second certifying doctor is also an obstetrician, either one may carry out the procedure.
The provisions in the 2018 Act reflect the recommendations made by the Joint Committee on the Eighth Amendment of the Constitution, published in December 2017.
The operation of the legislation is a matter for attending clinicians. The appropriate medical body, the Institute of Obstetricians and Gynaecologists and Obstetricians based in the Royal College of Physicians of Ireland, has published Clinical Guidance on Termination of Pregnancy in a number of scenarios, including the Pathway for Management of Fatal Fetal Abnormalities and/or Life-Limiting Conditions Diagnosed During Pregnancy.
I should note that the Health (Regulation of Termination of Pregnancy) Act 2018 makes provision for review in cases where a medical practitioner has given an opinion that would not lead to certification for termination of pregnancy to be carried out. Section 13 of the Act provides that the pregnant woman, or a person acting on her behalf, may make an application to the HSE for a review of the relevant decision. Within three days of receiving such an application, the HSE must convene a committee of medical practitioners to review the relevant decision. The committee must complete its review not later than seven days from the date on which it was established.
Services for termination of pregnancy under the Health (Regulation of Termination of Pregnancy) Act 2018 have continued to function during the COVID-19 pandemic.
970. Deputy Róisín Shortall asked the Minister for Health the status of a paper (details supplied); and if his Department has acted on the proposal. [13476/21]
View answerFollowing the presentation of the paper referenced by the Deputy in February 2020, the onset of the Covid-19 pandemic led to a rapid reprioritisation of the Department’s activities to manage the health and social care system’s response to the crisis. As a result of this, the paper remains under deliberation by the Department of Health.
971. Deputy Róisín Shortall asked the Minister for Health the protocol in place to ensure that students who receive in-school speech and language therapy (details supplied) but do not meet the needs of the children’s disability networks teams do not lose access to these services when their provision is moved to the children's disability network teams; if the removal of in-school supports proposed is for all special schools or relates in particular to deaf education settings; and if he will make a statement on the matter. [13478/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible
972. Deputy Róisín Shortall asked the Minister for Health if he plans to cut the 300 additional medical intern posts which were created in April 2020 as a result of the pandemic; the consideration that has been given to the impact of such a cut on the health service and on medical graduates; and if he will make a statement on the matter. [13479/21]
View answerIn April 2020, due to the evolving COVID-19 situation the Department of Health supported the HSE request to commence the 2020 Medical Intern intake earlier than usual and to offer an Intern place to all eligible applicants for the 2020 Medical Intern year.
This increase was an emergency measure in direct response to the COVID-19 pandemic, it was not planned, and it was never intended, that this increase would be sustained on an annual basis.
Following the application process 992 interns commenced employment with the HSE on 25th of May 2020 which was 80% of the total interns eligible for places in 2020, 20% of candidates offered an intern post did not take up the offer.
The number of medical internship posts available for July 2021 has reverted, as planned to 734, which is the agreed annual intake in line with current workforce planning projections. The number of intern places is in line with the numbers of training posts available in specialist training programmes, the next step in the training pathway following completion of an internship.
As the HSE are coming out of the third wave of COVID-19 and facing increased waiting lists and other challenges the focus is on ensuring they have senior doctors to deal with the impact of COVID. As part of the planned investment by the HSE in additional staffing, services and infrastructure the HSE will be investing in additional medical staffing in 2021. The HSE has:
- Increased the number of approved postgraduate training places by 106 places for July 2021;
- Introduced up to 40 new COVID Era Senior Fellowship posts for July 2021;
- Increase of 91 approved consultant posts since August 2020. Further increases are planned as part of the HSE National Service Plan.
These additional consultants and other senior decision makers will support the delivery of shorter waiting times, the reduction of hospital admissions, improved patient flow, and earlier discharge of patients to the community.
The HSE intend to review the number of intern posts in a planned and targeted manner for July 2022 to ensure any increases in intern posts aligns with projected workforce planning and postgraduate training positions. The outcome of this review with the recommended number of intern places for July 2022 will be presented to the Department of Health, later this year.
The Department of Health supports this review and welcomes it as timely in line with health reforms due to COVID-19 and planned Sláintecare reforms.
973. Deputy Róisín Shortall asked the Minister for Health if he will commission a report on the role of vitamin D in immunological health as it relates to same, given the evidence that vitamin D has a causal relationship to SARS-CoV2 infection and Covid-19 disease and the evidence for population supplementation; and if he will make a statement on the matter. [13480/21]
View answerWith regard to Vitamin D supplementation in the population, the Deputy is advised that the existing guidance on vitamin D was updated in November 2020 and advises that adults aged 65 and older to take a 15 microgram (600 IU) daily supplement for bone and muscle health.
An evidence synthesis paper on vitamin D and COVID-19 prepared for the NPHET was discussed at its meeting on 28th January 2021. The NPHET agreed that at present, there is insufficient high-quality evidence with respect to vitamin D in the prevention and treatment of COVID-19, and noted that ongoing developments, particularly Randomised Control Trials, in this area be monitored by the NPHET with guidance reviewed accordingly.
The NPHET agreed that efforts should be made to increase awareness of existing guidance. Adults spending increased time indoors or those who are housebound or in long-term residential care or have dark skin pigmentation are also recommended to take a daily vitamin D supplement.
These recommendations for the use of vitamin D are being incorporated into wider messaging, and additionally are being communicated across the health service, including nursing homes and social care settings, as necessary.
The Department of Health has recently written to the HSE and Nursing Homes Ireland to encourage implementation of guidance on vitamin D in nursing homes.
The Government will continue to look to the NPHET to provide recommendations with regard to Vitamin D and COVID-19.
974. Deputy Róisín Shortall asked the Minister for Health the sequence of events including timelines that take place to transport vaccines from the point of arrival into the country on a plane or ship to the point of administration; and if he will make a statement on the matter. [13481/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
975. Deputy Róisín Shortall asked the Minister for Health if the IT system used to record vaccines administered was upgraded, as expected, in January 2021; and if he will make a statement on the matter. [13482/21]
View answerThe national Covid vaccination systems deployed in response to the pandemic, was upgraded in January and indeed continues to be developed and refined in response to the emerging needs of the Covid vaccination programme. Decisions regarding the definition of which cohorts/ groups of people will receive which vaccine, and in what type of location eg hospital, GP surgery, mass vaccination clinic, among others, can have significant impacts on the configuration of the system. A dedicated team with technical expertise within the HSE are engaged in this work with technical partners IBM and Salesforce.
976. Deputy Róisín Shortall asked the Minister for Health the capacity of the IT system used to record vaccines administered; if the IT system is capable of processing upwards of 40,000 records per day as will be required in April 2021 in order to meet the target of 1.2 million vaccinations that month; and if he will make a statement on the matter. [13483/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
977. Deputy Réada Cronin asked the Minister for Health the reason the psychologist post at Celbridge primary care centre, County Kildare, remains unfilled while waiting lists for psychological treatment lengthen and young children’s conditions deteriorate; the date for the post to be filled; and if he will make a statement on the matter. [13488/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
978. Deputy Réada Cronin asked the Minister for Health the number of Covid-19 vaccinations given by county by first dose only and by first and second dose; and if he will make a statement on the matter. [13489/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
979. Deputy Martin Browne asked the Minister for Health his views on the fact that the Medicinal Cannabis Access Programme does not include the prescription and funding of Dutch products for patients with specific conditions; the progress being made in resolving this issue (details supplied); his views on the need for patients to access these products; the reason Dutch products are not included under the access programme; and if he will make a statement on the matter. [13493/21]
View answerA prospective supplier of cannabis-based products can apply to the Health Products Regulatory Authority (HPRA), on behalf of the Minister, to have a cannabis-based product considered for inclusion in the Medicinal Cannabis Access Programme.
Cannabis-based products that can be used in the Medicinal Cannabis Access Programme are defined as ‘specified controlled drugs’ in legislation (SI 262/2019) and the definition outlines the specific requirements for those products.
The criteria that cannabis-based products must meet in order to be considered by the Minister for inclusion on the schedule are set out in the legislation and can be found in the operator guidance issued by the HPRA.
The manufacturers of the prescribed cannabis-based products availed of by patients (whose clinicians are licenced under the Misuse of Drugs Acts 1977-2016) from a pharmacy in the Netherlands have not sought to have their products included in the Medicinal Cannabis Access Programme.
Due to current Netherlands government policy, the prescribed cannabis-based oil formulations are not permitted to be commercially exported from the Netherlands but are only supplied in the Netherlands to Irish patients on an individual basis on foot of a valid medical prescription when presented to the appropriate pharmacy.
Representations were made to the Dutch authorities to facilitate the export of the products to Ireland. The Dutch authorities confirmed that the export of cannabis oils to foreign pharmacies or wholesalers is not permitted and that magistral preparations may only be provided directly to patients or their representative on the basis of a prescription.
In April 2020, as a result of the Covid 19 pandemic the Department initiated a collection and delivery process of cannabis-based products form the Netherlands to patients homes for patients of clinicians licenced under Section 14 of the Misuse of Drugs Acts to prescribe controlled substances to their patients and this was confirmed as a permanent measure in December 2020.
On commencement of the access programme clinicians and their patients can continue to avail of the licence pursuant to the Misuse of Drugs Acts 1977-2016.
980. Deputy John Lahart asked the Minister for Health if he plans to introduce a no fault compensation scheme to cover the Covid-19 vaccine programme in 2021; if the introduction of such a scheme would require primary legislation; if so, when this legislation will be drafted and introduced; and if he will make a statement on the matter. [13495/21]
View answerIn June 2018, the Government agreed to the establishment of an Expert Group to review the law of torts and the current systems for the management of clinical negligence claims chaired by High Court Justice Charles Meenan.
The Expert Group examined the system from the perspective of the person who has made the claim to explore if there is a better way to deal effectively yet more sensitively with certain cases. In this process the Group also looked at the impact of tort legislation on the overall patient safety culture and open disclosure. Judge Meenan submitted the final report of the Expert Group on the Reform of the Law of Torts and the Current System for Managing Clinical Negligence Claims to my myself and the Minister of Justice in January 2020, prior to the onset of the COVID-19 pandemic. The Government subsequently published the Meenan report in December 2020.
One of the report’s recommendations is that a compensation scheme be established to deal with certain vaccine damage claims.
On foot of a request from my Department, the Health Research Board (HRB) carried out an evidence review on vaccine injury redress programmes in other jurisdictions and this was completed in March 2019.
The Expert Group’s report, in addition to the HRB's evidence review, and consultation with other Government Departments and relevant State agencies will inform the development of any proposals regarding the establishment of a compensation scheme, including the need for primary legislation.
981. Deputy John Lahart asked the Minister for Health the status of the implementation of a national vaccine registry and the planned national immunisation information system; if a national registry will be in place to collect information on Covid-19 immunisation in 2021; and if he will make a statement on the matter. [13496/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
