Written Answers Nos. 1724-1742
1724. Deputy Cormac Devlin asked the Minister for Health if he will request his officials to investigate if a racecourse (details supplied) would be suitable for use as local Covid-19 mass vaccination centre for the south County Dublin, north County Wicklow regions; and if he will make a statement on the matter. [18789/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1725. Deputy Róisín Shortall asked the Minister for Health if a needs assessment and mapping exercise to identify the status of existing sexual health services and current gaps has been carried out as recommended in the National Sexual Health Strategy; his plans to carry out a similar exercise to specifically identify the needs of the LGBTQ+ community in this regard; and if he will make a statement on the matter. [18804/21]
View answerThe National Sexual Health Strategy, 2015-2020 was launched in October 2015. It takes a life course approach, acknowledging the importance of developing a healthy attitude to sexuality in young people and of building on that foundation for positive sexual health and wellbeing into adulthood and older age. It also recognises the importance of challenging stigma and discrimination and creating positive cultural change to promote open communication about relationships, sexuality, and sexual health and wellbeing.
The goals of the Strategy are:
- Everyone in Ireland to receive comprehensive and age-appropriate sexual health education/information and to have access to appropriate prevention and promotion services;
- Equitable, accessible and high-quality sexual health services, which are targeted and tailored to need, to be available to everyone; and
- Robust and high-quality sexual health information to be generated to underpin policy, practice, service planning and strategic monitoring.
Current priority deliverables under the Strategy are HIV prevention, including the Fast-Track Cities initiative and continued expansion of a Pre-Exposure Prophylaxis (PrEP) programme, which commenced in late 2019.
Other key areas of work include expanding access to contraception, free of charge, through the National Condom Distribution Service; provision of sexually transmitted infection (STI) services, progressing a population survey on sexual health and improving sexual health education, training and resources, including in schools, higher and further education and those for use by parents.
A 2018 mid-term review of the Sexual Health Strategy highlighted key contributors to success. These include the composition and expertise of the HSE Sexual Health and Crisis Pregnancy programme team, the cross functional approach (education, training, communications, funding, research, clinical) and the strong engagement and collaboration with stakeholders throughout all aspects of implementation of the strategy.
Given the breadth of the Sexual Health Strategy 2015-2020, the strategy remains relevant beyond its original timeframe. Consequently, and due to particular pressures during 2020 as a result of the pandemic, it has been agreed with the SHCPP to extend the lifetime of the current Strategy to the end of 2021. It is intended to review and refresh the Strategy in 2021 and work on this is commencing.
It is envisaged that, as part of the review process, focus group meetings with key stakeholders, including clinical and public health staff, the SHCPP team, those working in the STI clinics, the Education sector, the Department of Health and Women’s Health Taskforce, the research and academic sector and organisations representing the LGBTI+ community will be held to inform the future direction of the next iteration of the strategy.
1726. Deputy Claire Kerrane asked the Minister for Health if there are vacancies in the community (details applied) within the HSE. [18805/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy, as soon as possible.
1728. Deputy Réada Cronin asked the Minister for Health if his recent decision to prioritise vaccinations based on age took full account of the cascade effect in schools in which Covid-related teacher absences and the saturation of the substitute panel with requests is seeing special needs pupils frequently deprived of teachers forced to redeploy to cover such class teacher absences; and if he will make a statement on the matter. [18816/21]
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.
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.
On the 30th of March, the Government approved a further update to the COVID-19 Vaccination Allocation Strategy. Based on clinical, scientific and ethical frameworks produced by the National Immunisation Advisory Committee and my Department, following the vaccination of those most at risk, future groups will be vaccinated by age, in cohorts of 10 years (i.e., 64-55; 54-45, etc.).
The move to an age-based model better supports the programme objectives by:
- protecting those at highest risk of severe disease first, which benefits everyone most;
- facilitating planning and execution of the programme across the entire country;
- improving transparency and fairness.
Further details are available here: www.gov.ie/en/press-release/93f8f-minister-donnelly-announces-update-to-irelands-vaccination-prioritisation-list/.
There is no evidence to show a significantly increased risk of severe COVID-19 disease, independent of age and other comorbidities, in any occupational group to prioritise them for vaccination above their age-cohort.
1729. Deputy Mattie McGrath asked the Minister for Health if HIQA has or plans on re-examining the emerging evidence regarding the efficacy of ivermectin as a prophylactic and treatment for Covid-19; and if he will make a statement on the matter. [18818/21]
View answerI wish to advise the Deputy that the HIQA provides evidence-based advice in response to requests from the NPHET.
The HIQA previously undertook an evidence review Interventions in an ambulatory setting to prevent progression to severe disease in patients with COVID-19 which is published on www.hiqa.ie. This review included a number of studies of ivermectin.
For the Deputy's information, 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.”
An update of the above-mentioned evidence review is not planned at this time.
However, the Deputy may wish to note that the HIQA is currently undertaking an evidence review entitled COVID-19 - Interventions and lifestyle factors that prevent infection or minimise progression to severe disease. Any studies of ivermectin that meet the inclusion criteria outlined in the protocol published at www.hiqa.ie will be included. The HIQA is due to provide the evidence review and associated advice to the NPHET at its meeting on the 6th May 2021.
1730. Deputy Eoin Ó Broin asked the Minister for Health his plans to move from a psychiatric model of transgender healthcare to a model more in line with international best practice as outlined by the World Health Organisation. [18827/21]
View answer1880. Deputy Paul Murphy asked the Minister for Health if he will commence a review of healthcare for transgender and non-binary persons with a view to changing the system in order that it corresponds to the recommendations of an association (details supplied); and if he will make a statement on the matter. [19220/21]
View answerI propose to take Questions Nos. 1730 and 1880 together.
Government policy in relation to LGBTI+ citizens is set out in the National LGBTI+ Inclusion Strategy and the LGBTI+ National Youth Strategy, which fall under the responsibility of the Minister for Children, Disability, Equality, Integration and Youth. The National LGBTI+ Inclusion Strategy aims to improve the lives of the LGBTI+ citizens of Ireland through the promotion of inclusion, protection of rights and the improvement of the quality of life and wellbeing for LGBTI+ people. The LGBTI+ National Youth Strategy is an action-oriented mission to ensure all LGBTI+ young people are visible, valued and included, and arose from the National Youth Strategy which identified LGBT young people as a specific group to be considered in the context of focused provision for marginalised/disadvantaged young people.
Together these strategies play an important part in achieving the Government's broader commitment to continue to strive for the full inclusion of LGBTI+ people in Irish society. Actions relating to the health of LGBTI+ citizens fall to the Department of Health and the HSE.
A proposed model of care for transgender children, adolescents and adults has been developed by the HSE Quality Improvement Division. The model provides the framework for the development of National Gender Clinics and MDTs for children and adults. The emerging evidence on good outcomes following medical and/or surgical transitioning is based on use of multi-disciplinary psychosocial assessment, fulfilment of criteria for hormones and on-going psychological support throughout the process. Local and international evidence increasingly suggests that this multidisciplinary approach should be led by a child psychiatrist with an interest in child and adolescent gender identity.
The Department of Health is committed to the development by the HSE of a well-governed and patient-centred health care service for adults and children in the transgender community, in line with the Programme for Government.
1731. Deputy Duncan Smith asked the Minister for Health the up-to-date position on waiting lists in the CHO 7 area for assessment of need; the breakdown if available by county; the number of staff employed in the assessments; if there are staff vacancies; the type of vacancies; and if he will make a statement on the matter. [18828/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly.
1732. Deputy Duncan Smith asked the Minister for Health the reason families are waiting on therapists in the CHO 7 area of the HSE due to their children transferring to the school age groups; his plans to address these vacancies; the timelines involved; and if he will make a statement on the matter. [18829/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly.
1733. Deputy Duncan Smith asked the Minister for Health the up to date position with the primary care centre in Newbridge, County Kildare; the services located there; the services operating at the moment; and if he will make a statement on the matter. [18830/21]
View answerAs the HSE has responsibility for the provision, along with the maintenance and operation of Primary Care Centres and other Primary Care facilities, the Executive has been asked to reply directly to the Deputy.
1734. Deputy Duncan Smith asked the Minister for Health the up to date position with the primary care centre in Kildare town; the services located there; the services operating at the moment; and if he will make a statement on the matter. [18831/21]
View answerAs the HSE has responsibility for the provision, along with the maintenance and operation of Primary Care Centres and other Primary Care facilities, the Executive has been asked to reply directly to the Deputy.
1735. Deputy Sean Sherlock asked the Minister for Health the nature and cost of the contract of the head of Covid-19 test and trace system of the HSE; if such a position is a secondment from a private company on a pro bono basis; the name of the company from which the secondment is from; if the company is contracted to provide services to his Department or the HSE; if so, the basis on which and cost; and if he will make a statement on the matter. [18842/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1736. Deputy David Cullinane asked the Minister for Health if a local implementation board has been established in 2011 for Our Lady of Lourdes Hospital, Drogheda under the HSE obstetrics and gynaecology programme; the steps that have been taken to ensure implementation of recommendations of a report (details supplied); if these recommendations are currently being considered; and if he will make a statement on the matter. [18845/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1737. Deputy David Cullinane asked the Minister for Health the process established under the HSE to ensure that recommendations of a report (details supplied) published in 2011 are implemented; the level of oversight that exists in the event that a clinician and or hospital fails to implement recommendations; and if he will make a statement on the matter. [18846/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1738. Deputy Catherine Murphy asked the Minister for Health if he or NIAC have considered evidence relating to risk from exposure in the alteration of the priority list. [18848/21]
View answerThe aims of the vaccination programme are to ensure equitable access to safe and effective vaccines with the goals of limiting severe disease and death from COVID-19, protecting healthcare capacity and enabling social and economic activity.
The general approach taken by the National Immunisation Advisory Committee (NIAC) to prioritisation to help with planning for vaccine implementation is based on:
1. disease burden and severity in risk groups;
2. impact on society;
3. vaccine specific information; and
4. moral equality of the person, minimising harm, fairness, and reciprocity.
Evidence on transmission of COVID-19 following COVID-19 vaccination is limited. The main vaccine efficacy trials were not designed for this purpose. Evidence from Israel and the UK indicates that there is a reduction in infection in vaccinated individuals. Following vaccination, breakthrough infection is rare and when it occurs, there are lower levels of virus and a shorter duration of viral shedding. All of this reduces the likelihood of onward transmission.
At present, there is insufficient evidence on transmission to redirect the vaccination programme to focus primarily on interruption of transmission as prevention. Thus, the primary focus of the programme remains prevention of hospitalisation, severe disease and death.
There is no evidence to show a significantly increased risk of severe COVID-19 disease, independent of age and other comorbidities, in any occupational group to prioritise them for vaccination above their age-cohort.
In relation to exposure, all persons are advised to adhere to public health advice in relation to reducing risk of exposure to SARS-CoV-2 by maintaining a distance of 2 metres, wearing a mask, washing hands, respiratory and cough etiquette, keeping contacts to a minimum, and avoiding non-essential travel, all of which have been shown to reduce the risk of exposure to the virus.
1739. Deputy Catherine Murphy asked the Minister for Health if he has engaged with teacher and An Garda Síochána representative bodies in respect of the revised vaccine roll-out plan; and if not, if he plans on engaging with same. [18849/21]
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.
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.
On the 30th of March, the Government approved a further update to the COVID-19 Vaccination Allocation Strategy. Based on clinical, scientific and ethical frameworks produced by the National Immunisation Advisory Committee and my Department, following the vaccination of those most at risk, future groups will be vaccinated by age, in cohorts of 10 years (i.e., 64-55; 54-45, etc.).
The move to an age-based model better supports the programme objectives by:
- protecting those at highest risk of severe disease first, which benefits everyone most;
- facilitating planning and execution of the programme across the entire country;
- improving transparency and fairness.
Further details are available here: www.gov.ie/en/press-release/93f8f-minister-donnelly-announces-update-to-irelands-vaccination-prioritisation-list/.
1740. Deputy Catherine Murphy asked the Minister for Health his plans to roll-out vaccines to home carers outside of the revised vaccine roll-out plan; and if this cohort can avail of spare vaccines at short notice. [18850/21]
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.
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.
On the 30th of March, the Government approved a further update to the COVID-19 Vaccination Allocation Strategy. Based on clinical, scientific and ethical frameworks produced by the National Immunisation Advisory Committee and my Department , following the vaccination of those most at risk, future groups will be vaccinated by age, in cohorts of 10 years (i.e., 64-55; 54-45, etc.).
The move to an age-based model better supports the programme objectives by:
- protecting those at highest risk of severe disease first, which benefits everyone most;
- facilitating planning and execution of the programme across the entire country;
- improving transparency and fairness.
Further details are available here: www.gov.ie/en/press-release/93f8f-minister-donnelly-announces-update-to-irelands-vaccination-prioritisation-list/.
In relation to family carers, it is important to note that:
a) carers who are healthcare workers are at a very high or high risk of exposure to the virus. In the first wave of the pandemic, over 30% cases were in healthcare workers. Whereas, family carers operate in a completely different and more controlled environment and do not have the same risk of exposure to the virus;
b) family carers can minimise their contacts, employ physical distancing, hand washing, respiratory and cough etiquette and, hence, minimise their risk of infection and, thereby, the risk of transmitting infection to a vulnerable person;
c) there is emerging evidence that is encouraging regarding the ability of COVID-19 vaccines to impact viral transmission. However, there is insufficient evidence at the current time to justify a change from the current strategy of prioritising those at increased risk of severe disease and/or death as a consequence of COVID-19, to one aimed at reducing transmission.
1741. Deputy Jackie Cahill asked the Minister for Health if a person (details supplied) can be assessed by a clinical psychologist; and if he will make a statement on the matter. [18851/21]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
1742. Deputy David Cullinane asked the Minister for Health the costs incurred to date by the CervicalCheck Tribunal; and if he will make a statement on the matter. [18859/21]
View answer1785. Deputy David Cullinane asked the Minister for Health the costs to date of the setting up and operation of the CervicalCheck Tribunal; and if he will make a statement on the matter. [18971/21]
View answer2197. Deputy David Cullinane asked the Minister for Health the costs incurred to date by the CervicalCheck Tribunal by cost type, for example, salaries, public relations, legal fees, rent and so on; and if he will make a statement on the matter. [20109/21]
View answerI propose to take Questions Nos. 1742, 1785 and 2197 together.
The CervicalCheck Tribunal is based in the Infinity Building in Smithfield in office space that has been fitted out to meet the Tribunal’s requirements including:
- Three hearing rooms
- A counter and reception area
- Consultation rooms and a larger meeting room that can be used by claimants and their legal representatives
- Comfortable private rooms for use by claimants when they are not in hearings.
- Offices for Tribunal staff
- Chambers for the Tribunal Members
The amount expended on the fit out for the Tribunal by the Office of Public Works (OPW) to date is €1,627,645. This includes construction fit-out costs, consultants fees, vat and per cent for art allowance. As this was a ‘first use’ fitout, a significant portion of this expenditure would have been required irrespective of the usage to which the accommodation was put.
The building occupied by the Tribunal is leased by the OPW on a long-term basis. A pro-rata allocation of the leasehold cost entails a spend of €303,144 per annum to provide accommodation for the Tribunal. A further €112,315 per annum is spent on service charges.
The amounts paid by my department in respect of the set up and operation of the Tribunal to the end of March 2021 are set out in the Table below. These costs include one off set up costs that are in addition to the fit out costs referred to above, as well as ongoing costs for the operation of the Tribunal.
|
Category |
Total |
|
Advertising/Media |
€4,287 |
|
Cleaning |
€13,438 |
|
Furniture and Fittings |
€140,076 |
|
IT/AV |
€45,836 |
|
Legal |
€27,162 |
|
Office |
€6,018 |
|
Printing |
€9,346 |
|
Security |
€424 |
|
Total |
€246,587 |
The figures above are provisional and at this time it is not possible to provide a breakdown between the cost of setting up the Tribunal and costs incurred by the Tribunal in its ongoing operation.
The CervicalCheck Tribunal Act 2019 (the 2019 Act) requires the Tribunal to submit a report to me in respect of its activities during each financial year. This report must include particulars of its accounts.
Under the 2019 Act I am required to determine the remuneration of Tribunal Members other than those who are serving judges of the Superior Courts. I can confirm that the ordinary member of the Tribunal who is a retired judge of the Court of Appeal is paid at the rate of remuneration currently applicable to a judge of that Court.
The cost of staffing the Tribunal to the end of March 2021, including both set up and operational costs post establishment, has been €277,176. This figure includes employer’s PRSI.
