Wednesday, 24 Mar 2021

Covid-19 Pandemic

Questions (1353, 1428)

Marian Harkin

Question:

1353. Deputy Marian Harkin asked the Minister for Health the point in the vaccination programme SNAs will receive their vaccination; and if he will make a statement on the matter. [14032/21]

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Joe Flaherty

Question:

1428. Deputy Joe Flaherty asked the Minister for Health if there are plans to prioritise private sector special needs education workers in the vaccine roll-out given that they are providing an invaluable service to families and in view of the fact colleagues in the HSE have already been vaccinated. [14185/21]

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Written answers

Minister for Health

I propose to take Questions Nos. 1353 and 1428 together.

On the 23rd of February 2021, 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 next cohort to be vaccinated (Cohort 4) are those aged 16-69 and at very high risk of severe illness and death. Vaccination of this group began in March.

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.

It is important to emphasise that vaccination is only one part of our response to the prevention of COVID-19 infection. People who are vaccinated need to continue with all the public health measures that have been proven to reduce the risk of infection, i.e., limiting our social contacts, physical distancing, wearing a mask, hand hygiene, cough etiquette and avoiding non-essential travel until a sufficiently large proportion of the population are immune.

Covid-19 Pandemic

Questions (1354, 1666, 1927)

Marian Harkin

Question:

1354. Deputy Marian Harkin asked the Minister for Health if there are plans to include radiographers and radiation therapists on the list of professions in SI 698 of 2020; and if he will make a statement on the matter. [14033/21]

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Donnchadh Ó Laoghaire

Question:

1666. Deputy Donnchadh Ó Laoghaire asked the Minister for Health if his Department has considered allowing dental hygienists to participate in the national roll-out of Covid-19 vaccinations as vaccinators. [15027/21]

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Holly Cairns

Question:

1927. Deputy Holly Cairns asked the Minister for Health his views on permitting dental hygienists to participate in the national roll-out of Covid-19 vaccinations as vaccinators; and if he will make a statement on the matter. [15918/21]

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Written answers

Minister for Health

I propose to take Questions Nos. 1354, 1666 and 1927 together.

The 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.

In addition, on Tuesday 23 February 2021, I signed the Medicinal Products (Prescription and Control of Supply) (Amendment) (No. 4) Regulations 2021. The purpose of these amending Regulations is to add registered optometrists and registered dentists to the list of professionals who may supply and administer Covid-19 vaccinations.

The vaccine roll out is being conducted on a 7-day week basis and to date, more than 10,900 staff have received training to operate as vaccinators. To support the expanded immunisation programme the HSE launched a vaccinator recruitment campaign at the end of February.

It is not intended that radiographers, radiation therapists or dental hygienists will be called upon to participate as vaccinators in the programme at this time.

National LGBTI+ Strategy

Questions (1355)

Ruairí Ó Murchú

Question:

1355. Deputy Ruairí Ó Murchú asked the Minister for Health the details of engagements to date on work regarding the legislative ban on conversion therapy as committed to in the programme for Government; the timeline for commencement; and if he will make a statement on the matter. [14040/21]

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Written answers

Minister of State at the Department of Health

The Programme for Government: Our Shared Future commits to legislate to ban conversion therapy.

The Government approach to legislating on conversion therapy is set out in the LGBTI+ Inclusion Strategy. It states that the practice of conversion therapy will be investigated and followed up with appropriate counter measures. The strategy sets out two specific actions:

1. research on the extent of the practice of conversion therapy and international best practice in responding to conversion therapy, including legislative responses (to be undertaken by Department of Justice and Equality) and

2. the development of an appropriate package of measures for implementation (to involve all Government Departments.)

Separately, the Department of Health is aware of the Prohibition of Conversion Therapies Bill 2018, tabled in Seanad Éireann. The research proposed as part of the LGBTI+ Inclusion Strategy will provide an evidence base for a detailed consideration of the Bill. Furthermore, any legislative proposals arising will be strengthened if implemented as part of a whole of government response.

Medical Internships

Questions (1356)

Ruairí Ó Murchú

Question:

1356. Deputy Ruairí Ó Murchú asked the Minister for Health if consideration is being given to the development of allowances to support radiography students through their placements; and if he will make a statement on the matter. [14041/21]

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Written answers

Minister for Health

Radiography students do not receive an allowance to support time spent on placement as part of their course and there are no plans to change this.

I can confirm that in 2020, assistant radiographers were employed on a 3 month contract following completion of their final year clinical placement, subject to the needs of the Health Service. As their skills were identified as being required during the COVID-19 response and subject to the needs of each acute hospital, they were offered a temporary 3 month assistant radiographer role following successful completion of their 7 week final year clinical placement. The 3-month period commenced on 18 May 2020.

It should be noted that across the health and social care disciplines, there could be over 8,000 students on placement in hospital and healthcare settings. Of this number, around a third are final year students. The length of placements and the activities performed during these placements vary between the disciplines. These students are not employees and in many cases the nature of the placement can, in the main, be limited to participation in an observing and a learning capacity.

Uniquely for student nurses and midwives there is, in the final year, a paid salary when they are specifically employed on an internship placement. Student nurses and midwives’ final year internship placement consists of a continual 36-week rostered clinical placement, including annual leave. The internship placement is a paid placement as the student nurses and midwives take a reduced caseload. During these placements, students are under supervision and are considered as 0.5 WTE of the workforce. In addition, Intern students can be allocated across all shift patterns including nights, weekends and 12-hour days.

Student nurses and midwives undertaking unpaid supernumerary clinical placement as students are currently in receipt of an allowance. Again, given the unique requirements of these training programmes attendance at many placement sites is required, some of which are at a distance to base training hospital and the current allowance is to contribute to the cost of alternative accommodation / travel.

Covid-19 Pandemic

Questions (1357)

Matt Shanahan

Question:

1357. Deputy Matt Shanahan asked the Minister for Health if his Department or HIQA have examined the possibly introducing Ivermectin as a possible Covid-19 treatment; and if he will make a statement on the matter. [14047/21]

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Written answers

Minister for Health

The Deputy is advised that, at the request of the NPHET, the HIQA conducted a rapid evidence review to identify studies on the effectiveness of (i) pharmaceutical and (ii) non-pharmaceutical interventions, in the ambulatory setting, aimed at reducing progression to severe disease in individuals with confirmed or suspected COVID-19. This evidence review included a review of relevant studies in relation to Ivermectin.

Low certainty or very low certainty evidence was identified in relation to a small number of interventions. However, the HIQA noted the low quality of the evidence available including the high risk of bias, small sample sizes and short durations of follow-up different trials and advised that results from these studies should not be used to inform decision-making with respect to effectiveness.

The HIQA’s overall finding was that there is currently insufficient evidence of either effectiveness or safety to support the use of any pharmaceutical intervention in the community setting to reduce the risk of progression to severe disease in patients who have been diagnosed with COVID-19 unless as part of an ongoing monitored clinical trial. Furthermore, no evidence was identified for the effectiveness or safety of any non-pharmaceutical intervention in the community setting.

As confirmed by the HIQA’s COVID-19 Expert Advisory Group: (https://www.hiqa.ie/sites/default/files/2021-02/Interventions-to-prevent-progression_Advice.pdf), evidence regarding the effectiveness of pharmaceutical treatments intended for systemic use, must be subject to the highest standards of rigour. Where a pharmaceutical intervention is recommended in the absence of appropriate supportive evidence, there is a significant potential for harm to the patient. Whereas this risk of harm may be justified in certain circumstances (e.g. the intervention poses minimal risk, or the setting involves patients with high potential to gain due to almost certain risk of severe adverse consequences in absence of any intervention) this is less likely to be the case in the setting of mild disease, where a great number of otherwise well patients would potentially receive the intervention.

The HIQA has also advised my Department that several international health technology assessment or guideline development organisations have specifically reviewed the evidence to date on ivermectin in COVID-19 and have cautioned or advised against the use of ivermectin outside the setting of clinical trials on the basis of the current evidence. The HIQA has also advised that the pharmaceutical company MSD (Merck, USA), which holds a license in the USA for the use of ivermectin as an antiparasitic agent, on 4th February 2021 published a statement including the following:

“It is important to note that, to-date, our analysis has identified:

- No scientific basis for a potential therapeutic effect against COVID-19 from pre-clinical studies;

- No meaningful evidence for clinical activity or clinical efficacy in patients with COVID-19 disease, and;

- A concerning lack of safety data in the majority of studies.

We do not believe that the data available support the safety and efficacy of ivermectin beyond the doses and populations indicated in the regulatory agency-approved prescribing information.”

I trust that the above information satisfactorily addresses your question.

Medical Internships

Questions (1358)

Matt Shanahan

Question:

1358. Deputy Matt Shanahan asked the Minister for Health if his attention has been drawn to issues in relation to students radiographers (details supplied); his plans to standardise allowances, placement grants and payment for work carried out; if he will meet with representatives of the group to discuss the challenges being faced; and if he will make a statement on the matter. [14048/21]

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Written answers

Minister for Health

Radiography students do not receive an allowance to support time spent on placement as part of their course and there are no plans to change this.

I can confirm that in 2020, assistant radiographers were employed on a 3 month contract following completion of their final year clinical placement, subject to the needs of the Health Service. As their skills were identified as being required during the COVID-19 response and subject to the needs of each acute hospital, they were offered a temporary 3 month assistant radiographer role following successful completion of their 7 week final year clinical placement. The 3-month period commenced on 18 May 2020.

It should be noted that across the health and social care disciplines, there could be over 8,000 students on placement in hospital and healthcare settings. Of this number, around a third are final year students. The length of placements and the activities performed during these placements vary between the disciplines. These students are not employees and in many cases the nature of the placement can, in the main, be limited to participation in an observing and a learning capacity.

Uniquely for student nurses and midwives there is, in the final year, a paid salary when they are specifically employed on an internship placement. Student nurses and midwives’ final year internship placement consists of a continual 36-week rostered clinical placement, including annual leave. The internship placement is a paid placement as the student nurses and midwives take a reduced caseload. During these placements, students are under supervision and are considered as 0.5 WTE of the workforce. In addition, Intern students can be allocated across all shift patterns including nights, weekends and 12-hour days.

Student nurses and midwives undertaking unpaid supernumerary clinical placement as students are currently in receipt of an allowance. Again, given the unique requirements of these training programmes attendance at many placement sites is required, some of which are at a distance to base training hospital and the current allowance is to contribute to the cost of alternative accommodation / travel.

Hospital Staff

Questions (1359)

Matt Shanahan

Question:

1359. Deputy Matt Shanahan asked the Minister for Health the steps he is prepared to take to rectify a matter in relation to non-consultant hospital doctors (details supplied); and if he will make a statement on the matter. [14049/21]

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Written answers

Minister for Health

NCHDs access two employment permit types, the Critical Skills Employment Permit (CSEP) and the General Employment Permit (GEP). A General Employment Permit is typically granted for NCHDs, as an offer of employment for two years is not required. A Critical Skills Permit may be granted to an NCHD where an employer is offering employment for two years. Either permit can now be issued on a multi-site basis if required, subject to relevant conditions attached to both permits being met. Critical Skills Employment Permits are already available to other healthcare professionals such as nurses and this change brings NCHDs in line with these staff categories. In 2020, the Department of Enterprise, Trade and Employment granted 169 Critical Skills Employment Permit issued to Doctors.

So far in 2021, the Department of Enterprise, Trade and Employment has granted 25 Critical Skills Employment Permits to Doctors. The HSE would anticipate that this number is likely to increase as the vast majority of doctors’ employment permits commence from the month of July.

Employment permits are now facilitated on a multi-site basis for all NCHDs where this is applied for by employers. This means that where an NCHD rotates between employers they may be granted one employment permit for a defined period and this single permit will cover all of their rotations.

Covid-19 Tests

Questions (1360)

Matt Shanahan

Question:

1360. Deputy Matt Shanahan asked the Minister for Health if he has taken steps to review and recommend antigen testing to screen test pupils in schools (details supplied); and if he will make a statement on the matter. [14050/21]

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Written answers

Minister for Health

The HSE has deployed ADTs for use in 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.

Considerable work has been undertaken to date to evaluate the use of ADTS in an Irish context and this will continue on an ongoing basis due to the role they can have in the national testing strategy. In particular, further setting-specific ADT validation work continues to be undertaken by the HSE. Antigen testing will not, however, replace the requirement for large scale PCR testing which remains the gold standard for community testing.

I have also set up a group, chaired by the government’s chief scientific adviser, Professor Mark Ferguson, to examine the use of rapid tests in the community, and I will be considering the recommendations of this group.

On an ongoing basis, NPHET considers and reviews, based on public health risk assessments, how best to target testing to detect, and mitigate the impact of, the virus across the population. This includes keeping Ireland’s national testing policy under continuing review.

Hospital Data

Questions (1361)

Matt Carthy

Question:

1361. Deputy Matt Carthy asked the Minister for Health the healthcare staff-to-patient ratio at Drogheda Hospital; the recommended healthcare staff-to-patient ratio for the hospital; and if he will make a statement on the matter. [14051/21]

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Written answers

Minister for Health

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly as soon as possible.

Covid-19 Pandemic

Questions (1362)

Matt Carthy

Question:

1362. Deputy Matt Carthy asked the Minister for Health if volunteers working with community programmes such as meals on wheels will be considered for prioritisation in the Covid-19 vaccination roll-out; and if he will make a statement on the matter. [14052/21]