Written Answers Nos. 1303-1327
1303. Deputy Joe Carey asked the Minister for Health if he will respond to reports regarding the loss of newly qualified doctors in counties Clare and Limerick (details supplied); if this decision will be reversed to enable these doctors to stay and continue to serve in the health service here; and if he will make a statement on the matter. [13886/21]
View answerOver the past number of weeks, my Department and the HSE have been reviewing the option to increase the number of medical intern places for July 2021.
I have announced an increase of 120 medical intern posts for July 2021. The increase in the number of intern places will be supported with accompanying increases in postgraduate training places, to ensure these doctors can avail of the next step in the training pathway following completion of an internship.
The six Intern Training Networks, that organise and oversee intern training in Ireland, are responsible for the allocation of intern posts within their particular networks. The networks have now been informed of the additional intern posts for July 2021, and will allocate the additional posts appropriately.
1304. Deputy David Cullinane asked the Minister for Health when an assessment date for a primary medical certificate will issue for a person (details supplied). [13887/21]
View answerThe 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) Community Medical Doctors 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.
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 HSE to recommence assessments from 1st January, 2021.
The ability to hold assessments has been impacted by, among other things, the public health restrictions in place to suppress and manage the spread of COVID-19. Unfortunately there are delays in the processing of assessments due to the involvement of the HSE Medical Doctors in the national COVID-19 response, which I know are causing undue strain on applicants.
I recently met with the HSE to discuss the issues around the delay in accessing Primary Medical Certificate assessments. The HSE has confirmed that it is continuing to monitor the situation in the context of resuming the range of services that are provided by Community Medical Doctors under the HSE Service Recovery and Restoration Plan, taking into account the pressures and challenges to the health services presented by COVID.
As the Deputy's question relates to a service matter, I have arranged for the question to be referred to the HSE for consideration and direct reply to the Deputy.
1305. Deputy Niall Collins asked the Minister for Health if he will respond to matters raised in correspondence by a person (details supplied); and if he will make a statement on the matter. [13889/21]
View answerOver the past number of weeks, my Department and the HSE have been reviewing the option to increase the number of medical intern places for July 2021.
I have announced an increase of 120 medical intern posts for July 2021. The increase in the number of intern places will be supported with accompanying increases in postgraduate training places, to ensure these doctors can avail of the next step in the training pathway following completion of an internship.
Over the next number of months, the HSE will be undertaking a formal review of the number of intern posts and postgraduate training positions to ensure the number of intern places are in line with future medical workforce planning requirements of the health service. As part of this review the clinical sites where additional intern posts are most needed will be considered to ensure that the current configuration provides the most efficient and educationally appropriate model.
1306. Deputy Fergus O'Dowd asked the Minister for Health the steps persons should take in cases in which they have a body mass index, BMI, above 40 and are included in the new cohort 4 but are not registered with a consultant or health team; the way such a person can ensure that they are registered for a vaccine if cohort 4 is advised that they will be contacted directly (details supplied); and if he will make a statement on the matter. [13894/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1307. Deputy Sean Sherlock asked the Minister for Health the status of a primary medical certificate application in respect of a person (details supplied) in County Cork. [13910/21]
View answerThe 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) Community Medical Doctors 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.
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 HSE to recommence assessments from 1st January, 2021.
The ability to hold assessments has been impacted by, among other things, the public health restrictions in place to suppress and manage the spread of COVID-19. Unfortunately there are delays in the processing of assessments due to the involvement of the HSE Medical Doctors in the national COVID-19 response, which I know are causing undue strain on applicants.
I recently met with the HSE to discuss the issues around the delay in accessing Primary Medical Certificate assessments. The HSE has confirmed that it is continuing to monitor the situation in the context of resuming the range of services that are provided by Community Medical Doctors under the HSE Service Recovery and Restoration Plan, taking into account the pressures and challenges to the health services presented by COVID.
As the Deputy's question relates to a service matter, I have arranged for the question to be referred to the HSE for consideration and direct reply to the Deputy.
1308. Deputy John Lahart asked the Minister for Health if his attention has been drawn to the fact that only a very limited number of intern jobs are available for medical students who have studied in Ireland; his plans to increase the number of intern positions available to help with understaffing of the health system; his views on whether such an increase in intern places would prevent newly qualified doctors from leaving to find work elsewhere; and if he will make a statement on the matter. [13912/21]
View answerOver the past number of weeks, my Department and the HSE have been reviewing the option to increase the number of medical intern places for July 2021.
I have announced an increase of 120 medical intern posts for July 2021. The increase in the number of intern places will be supported with accompanying increases in postgraduate training places, to ensure these doctors can avail of the next step in the training pathway following completion of an internship.
Over the next number of months, the HSE will be undertaking a formal review of the number of intern posts and postgraduate training positions to ensure the number of intern places are in line with future medical workforce planning requirements of the health service. As part of this review the clinical sites where additional intern posts are most needed will be considered to ensure that the current configuration provides the most efficient and educationally appropriate model.
1309. Deputy Neale Richmond asked the Minister for Health his plans to increase funding for the treatment for eating disorders; and if he will make a statement on the matter. [13913/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
1310. Deputy Neale Richmond asked the Minister for Health the number of treatment spaces nationwide for treating eating disorders; his views on whether this is an appropriate amount; and if he will make a statement on the matter. [13914/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
1311. Deputy Neale Richmond asked the Minister for Health the length of the waiting list for treatment for an eating disorder; and if he will make a statement on the matter. [13915/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
1312. Deputy Neale Richmond asked the Minister for Health the reason he does not plan to ensure that all medical students in Ireland will receive an intern position upon graduation as was the case for the 2020 graduating class; and if he will make a statement on the matter. [13917/21]
View answerOver the past number of weeks, my Department and the HSE have been reviewing the option to increase the number of medical intern places for July 2021.
I have announced an increase of 120 medical intern posts for July 2021. The increase in the number of intern places will be supported with accompanying increases in postgraduate training places, to ensure these doctors can avail of the next step in the training pathway following completion of an internship.
Over the next number of months, the HSE will be undertaking a formal review of the number of intern posts and postgraduate training positions to ensure the number of intern places are in line with future medical workforce planning requirements of the health service. As part of this review the clinical sites where additional intern posts are most needed will be considered to ensure that the current configuration provides the most efficient and educationally appropriate model.
1313. Deputy Neale Richmond asked the Minister for Health the steps he will take to tackle the shortage of doctors in Ireland, especially outside Dublin; his views on whether offering an intern position to all graduating medical students, as was done in 2020, would help to alleviate this shortage; and if he will make a statement on the matter. [13918/21]
View answerOver the past number of weeks, my Department and the HSE have been reviewing the option to increase the number of medical intern places for July 2021.
I have announced an increase of 120 medical intern posts for July 2021. The increase in the number of intern places will be supported with accompanying increases in postgraduate training places, to ensure these doctors can avail of the next step in the training pathway following completion of an internship.
Over the next number of months, the HSE will be undertaking a formal review of the number of intern posts and postgraduate training positions to ensure the number of intern places are in line with future medical workforce planning requirements of the health service. As part of this review the clinical sites where additional intern posts are most needed will be considered to ensure that the current configuration provides the most efficient and educationally appropriate model.
1314. Deputy Ged Nash asked the Minister for Health if CHO8 sought the assistance of the Defence Forces in supporting nursing homes in the region at any point in 2020; and if he will make a statement on the matter. [13919/21]
View answerAs this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1315. Deputy Ged Nash asked the Minister for Health if the HSE CHO8 will report on the number of freedom of information, FOI, requests in cases in which a charge of €200 or more was estimated for the provision of items before appeal in the past 12 months; and if he will make a statement on the matter. [13920/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible. The HSE is an Independent body for the purposes of FOI and has sole responsibility for compliance with the legislation in relation to HSE matters.
1316. Deputy Ged Nash asked the Minister for Health the reports on deaths and Covid-19 outbreaks HIQA requires from nursing home providers; and if he will make a statement on the matter. [13921/21]
View answer1317. Deputy Ged Nash asked the Minister for Health the methodology, evidence, depth and expertise required in reports on deaths and Covid-19 outbreaks HIQA requires from nursing home providers; and if he will make a statement on the matter. [13922/21]
View answer1318. Deputy Ged Nash asked the Minister for Health if HIQA requires only the view and opinion of the providers and not that of independent experts in the reports on Covid-19 outbreaks and deaths in facilities requested from nursing home providers; if HIQA also seeks alternative independent opinions on the causes of outbreaks and deaths in nursing homes; if not, if it solely accepts the reports of the providers; and if he will make a statement on the matter. [13923/21]
View answer1320. Deputy Ged Nash asked the Minister for Health if it is the policy of HIQA that no inquiry, investigation or examination is needed into any deaths in any nursing home as a result of the Covid-19 pandemic; and if he will make a statement on the matter. [13925/21]
View answerI propose to take Questions Nos. 1316 to 1318, inclusive, and 1320 together.
The Chief Inspector of Social Services within HIQA has statutory responsibility for the registration and inspection of nursing homes and other residential services for children and adults with disabilities. As part of her legal remit, the Chief Inspector can inspect nursing homes and other residential settings and can make binding decisions relating to the safety and quality of care provided to residents following inspection.
The Chief Inspector has a suite of statutory civil and criminal enforcement tools at her disposal where it is determined that the registered provider is not in compliance with their statutory duties and where the health or welfare of residents are at serious risk. These tools range from the issue of statutory demands for information to the cancellation of registration. Where a registered provider fails to discharge their statutory duties they are liable to prosecution before the courts.
The person in charge of a nursing home has a legal obligation to submit monitoring notifications to the Office of the Chief Inspector of the occurrence of certain events in the centre, including any case or suspected cases of COVID-19 among residents or staff.
The duties of the person in charge and the registered provider in relation to these monitoring notifications are set out in the Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2013, as amended, specifically in Regulation 31 and Schedule 4.
Monitoring notifications that must be submitted by the person in charge of a nursing home within three days of the event occurring and that are directly relevant to HIQA’s response to COVID-19 include:
- The unexpected death of any resident , including the death of any resident following transfer to hospital from the designated centre; and
- Any outbreak of any notifiable disease, including Covid-19.
HIQA reviews these notifications daily as an indicator of the extent of COVID-19 outbreaks in individual nursing homes and across the sector. An established communication pathway ensures that information pertaining to an outbreak is shared in a timely fashion between the HSE crisis management teams and the Office of the Chief Inspector.
I am advised by HIQA that Inspectors have carried out inspections in many nursing homes either during or following an outbreak. To date the Chief Inspector has not requested the input of an independent expert as it considers Public Health to be the definitive authority in managing this Public Health Emergency.
HIQA has submitted a document to my colleague, Minister for Health, Stephen Donnelly, which recommends a review of the current legislative and regulatory framework. A bilateral group has been established between officials in my Department and representatives from the Office of the Chief Inspector, for engagement on this matter.
HIQA encourages every provider who has experienced an outbreak of COVID-19 in their centre to complete a post outbreak review and to ensure that any learning from an outbreak is actioned. In addition, each registered provider is required to complete an annual review of the quality and safety of care delivered to residents in the designated centre to ensure that such care is in accordance with relevant standards set by the Authority.
1319. Deputy Ged Nash asked the Minister for Health his views on whether in-house reports on Covid-19 outbreaks and deaths created solely by the nursing home management are adequate to report on, address concerns and ensure learning about outbreaks of Covid-19 and the deaths and infection of residents; and if he will make a statement on the matter. [13924/21]
View answerNursing home providers are ultimately responsible for the safe care of their residents. Reports of this nature are completed by registered providers. I am advised by HIQA that its inspections are focused on reviewing the systems in place to ensure safe care for residents. To this end the Chief Inspector published “COVID-19 – an assurance framework for providers” last September to ensure that providers are continuously reviewing their service and making changes as new information / guidance becomes available or following an outbreak. Inspectors may ask to review the associated providers self-assessment and quality improvement document.
Where inspectors are concerned that the provider may not have addressed issues which were identified during an outbreak these will be reviewed – if the solution is allowed for in the current legal and regulatory framework then compliance is required. Where inspectors are not assured that the provider has the expertise to address issues of concern (particularly in the area of infection prevention and control) then a request can be made to the HSE crisis response team to support the provider in addressing these issues.
The Nursing Homes Expert Panel was established, on foot of a NPHET recommendation, to examine the complex issues surrounding the management of COVID-19 among this particularly vulnerable cohort. This Expert Panel report has added further to our knowledge and learning. This report clearly outlines the key protective measures that we must ensure are in place across our nursing homes. These actions are based on learning from our own and the international experience of COVID-19 to date.
The report also recommends additional analysis and examination of the relevant public health and other data sets in order that further causal and protective factors for COVID-19 clusters are identified.
Work to progress the recommendations of the Expert Panel report, particularly those recommendations requiring a priority focus in the response to COVID-19, is ongoing across all of the health agencies and stakeholders. Continued learning and understanding of progression of the disease in Ireland is an integral part of those recommendations.
1321. Deputy Ged Nash asked the Minister for Health if the CEO and chief inspector of HIQA have met with the families of any of those who died in nursing homes during the Covid-19 pandemic; if they are willing to do so; if not, the reason this is the case; and if he will make a statement on the matter. [13926/21]
View answerI am advised that HIQA, as an organisation, has been communicating on an ongoing basis with the families of deceased residents and from the outset have endeavoured to ensure all families have equitable access to relevant information and advice.
HIQA’s concerns team has had multiple contacts with family members and the team has endeavoured to take account of their experiences, answer their queries in relation to HIQA’s regulatory role, and signpost families appropriately to have their questions answered by the relevant agency. HIQA is satisfied that the systems that have been put in place are effective and will remain in place.
My Department liaised with the Chief Inspector in relation to facilitating access to advocacy services for residents of Dealgan House Nursing Home and their families and this service was subsequently made available by the Patient Advocacy Service.
1322. Deputy Ged Nash asked the Minister for Health the circumstances that are required to be met when HIQA requests weekly and regular reporting from nursing home and care facilities on the state of residents, including on issues such as weight and the prevalence of bedsores; the number of times such procedures were in place and used in 2020; and if he will make a statement on the matter. [13927/21]
View answerNursing home providers are ultimately responsible for the care and welfare of their residents and the quality of the service they provide.
I am advised by HIQA that requests for the level of reporting outlined by the Deputy will only arise where inspectors are concerned that residents living in a nursing home may be at risk of losing weight or developing a pressure sore. Such concerns may arise from the findings of an inspection, or through information received.
Such requests, which may be made during an inspection or in the reviewing of solicited or unsolicited information, are managed at individual case holder level. HIQA has advised that it is not possible to generate a report of the number of such requests made in a given time period.
1323. Deputy Ged Nash asked the Minister for Health his views on the call for independent, human rights focused inspections in nursing homes as suggested by organisations (details supplied); and if he will make a statement on the matter. [13928/21]
View answerHIQA is the national independent regulator of nursing homes and through its powers assesses whether residential services are providing high-quality, safe and effective services and supports for the people who live there.
HIQA has significant and wide-ranging powers up to and including withdrawing the registration of a nursing home facility, which means that it can no longer operate as a service provider. This responsibility is underpinned by a comprehensive quality framework comprising of Registration Regulations, Care and Welfare Regulations and National Quality Standards.
HIQA, in discharging its duties determines, through examination of all information available to it, including site inspections, whether a nursing home meets the regulations in order to achieve and maintain its registration status. HIQA reports on the regulations under two dimensions of:
1. Capacity and capability of the service:
This section describes the leadership and management of the centre and how effective it is in ensuring that a good quality and safe service is being provided. It outlines how people who work in the centre are recruited and trained and whether there are appropriate systems and processes in place to underpin the safe delivery and oversight of the service.
2. Quality and safety of the service:
This section describes the care and support people receive and if it was of a good quality and ensured people were safe. It includes information about the care and supports available for people and the environment in which they live. This includes assessments on resident’s rights (Section 9 of the regulations).
Should a nursing home be deemed to be non-compliant with the Regulations and the National Quality Standards, it may either fail to achieve or lose its registration status. In addition, the Chief Inspector has wide discretion in deciding whether to impose conditions of Registration on nursing homes. As part of the inspection, HIQA assesses whether the rights of people living in nursing homes have their rights respected.
The Nursing Homes Expert Panel was established, on foot of a NPHET recommendation, to examine the complex issues surrounding the management of COVID-19 among this particularly vulnerable cohort. This Expert Panel report has added further to our knowledge and learning. This report clearly outlines the key protective measures that we must ensure are in place across our nursing homes. These actions are based on learning from our own and the international experience of COVID-19 to date. The report also recommends additional analysis and examination of the relevant public health and other data sets in order that further causal and protective factors for COVID-19 clusters are identified.
Work to progress the recommendations of the Expert Panel report, particularly those recommendations requiring a priority focus in the response to COVID-19, is ongoing across all of the health agencies and stakeholders. Continued learning and understanding of progression of the disease in Ireland is an integral part of those recommendations.
The Expert Panel recommends that the Department of Health should explore a suitable structure and process for external oversight of individual care concerns arising in nursing homes, once internal processes have been exhausted without satisfaction. The Department is committed to progressing this. In addition, the Programme for Government commits to expand the remit of the Office of the Ombudsman to consider clinical decisions in health and social care complaints. This too will provide additional and welcome avenues for patient safety complaints.
Where a resident or family has a concern with regard to a regulated health professional such as a nurse or a doctor a complaint can be brought to the relevant regulator either the Nursing and Midwifery Board or the Irish Medical Council.
1324. Deputy David Cullinane asked the Minister for Health if advice will be provided on a matter raised in correspondence (details supplied); and if he will make a statement on the matter. [13936/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1325. Deputy Michael McNamara asked the Minister for Health if there will be a change in the vaccination programme regarding vaccination of persons who have been infected with and recovered from Covid-19 in view of the report by the Health Information and Quality Authority on post-Covid-19 infection immunity; and if he will make a statement on the matter. [13939/21]
View answerThe 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 review all data relating to COVID-19 vaccines on a rolling basis.
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 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.
You can read the guidelines at:
https://www.hse.ie/eng/health/immunisation/hcpinfo/guidelines/covid19.pdf
1327. Deputy Mairéad Farrell asked the Minister for Health the average and median ambulance waiting times in each of the years 2018 to 2020, by county in tabular form. [13945/21]
View answerAs this is a service matter I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
