Written Answers Nos. 1743-1761
1743. Deputy David Cullinane asked the Minister for Health if he will issue more detailed guidance on the definition of essential travel; if he considers family reunification as essential travel; and if he will make a statement on the matter. [18862/21]
View answer1923. Deputy David Cullinane asked the Minister for Health if he will address a matter in relation to essential travel (details supplied); and if he will make a statement on the matter. [19300/21]
View answerI propose to take Questions Nos. 1743 and 1923 together.
Ireland remains in Level 5 of the ‘Framework for Restrictive Measures in Response to COVID-19’ and due to the high level of disease and continuing risks associated with COVID-19, population wide measures remain in place.
The current Regulations in effect providing for public health restrictions are S.I. No. 168 of 2021 Health Act 1947 (Section 31A - Temporary Restrictions) (Covid-19) Regulations, 2021 (as amended)
The Regulations provide that a person shall not travel from their place of residence to an airport or port for the purpose of leaving the State without reasonable excuse. The list of reasonable excuses is non-exhaustive. It includes travel to give effect to arrangements for access to a child for parents or guardians of a child or a person who has a right of access to a child. It also includes travel to attend to a vital family matter.
Statutory Instruments related to the Covid pandemic are available online here: www.gov.ie/en/collection/1f150-view-statutory-instruments-related-to-the-covid-19-pandemic/.
1744. Deputy Bríd Smith asked the Minister for Health if the HSE has awarded contracts for home help work to a service (details supplied); the costs of such contracts from 2010 to date; and the number of hours involved. [18864/21]
View answer1745. Deputy Bríd Smith asked the Minister for Health if his attention has been drawn to plans by a service (details supplied) to cease operations and the transfer of workers to another service; the impact this will have on home help services in the area; and if he will make a statement on the matter. [18865/21]
View answer1746. Deputy Bríd Smith asked the Minister for Health if the HSE or his Department have been notified of the plan by a service (details supplied) to cease operations; and his views on plans by the HSE to continue with existing levels of home help hours for residents affected. [18866/21]
View answerI propose to take Questions Nos. 1744 to 1746, inclusive, together.
As these are operational matters, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1747. D'fhiafraigh Deputy Éamon Ó Cuív den Aire Sláinte cén líon daoine sa stát a chuir lámh ina mbás féin, briste síos de réir contae agus de réir aoise, gach bliain ó 2010 i leith; na beartais atá i bhfeidhm leis an líon seo a laghdú do na blianta atá romhainn; agus an ndéanfaidh sé ráiteas ina thaobh. [18882/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
1748. D'fhiafraigh Deputy Éamon Ó Cuív den Aire Sláinte cad iad na beartais atá beartaithe agus atá á gcur i bhfeidhm le seirbhisí feabhsaithe meabhairghalair agus síciatracha a chur ar fáil in Ospidéal Ollscoile na Gaillimhe; agus an ndéanfaidh sé ráiteas ina thaobh. [18883/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
1749. Deputy Éamon Ó Cuív asked the Minister for Health the number of patients currently waiting on surgery for breast cancer by three month intervals of time on the waiting list in tabular form; and if he will make a statement on the matter. [18886/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1750. Deputy Éamon Ó Cuív asked the Minister for Health the number of patients currently waiting on surgery for cancer by three month intervals of time on the waiting list in tabular form; and if he will make a statement on the matter. [18887/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1751. Deputy Éamon Ó Cuív asked the Minister for Health the number of cancer operations of the breast, prostate, colon, rectal, lung, ovarian and oesophageal that took place in each year since 2016, in tabular form; the percentage of these that took place within NCCP target surgery timeframes; and if he will make a statement on the matter. [18888/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1752. Deputy Éamon Ó Cuív asked the Minister for Health the number of cancer operations that took place in each year since 2016; the percentage of the procedures that took place in approved centres; and if he will make a statement on the matter. [18889/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1753. Deputy Matt Shanahan asked the Minister for Health if death rates in the elderly have coincided with vaccination; if his Department is reviewing corollary data between vaccination and deaths occurring; the way data on deaths is compiled and any lag times pertaining; and if he will make a statement on the matter. [18894/21]
View answerAs the Deputy will be aware, Ireland experienced a third wave of COVID-19 infection in late 2020/early 2021 which led to significant mortality and hospitalisations in the initial months of this year. The epidemiological situation has substantially improved since the peak of that wave in January, with the 14 day incidence reducing from a peak of 1,534 cases per 100,000 to a current rate of 114 cases per 100,000 on the 20 April. This has led to a corresponding significant reduction in hospitalisations and mortality. In terms of mortality, to date, a total of 1,399 COVID-19 related deaths have been reported as having occurred during January 2021, 860 in February, 221 in March and 45 in April to date.
We are already seeing the benefits of the vaccination programme, especially in those groups that have been prioritised for vaccination. For example, in the month of April to date, no new COVID-19 cases have been linked to Nursing Home outbreaks. The proportion of cases accounted for by persons aged 70 years decreased from 11.7% of total new cases during the second week of January, to only 3.1% of new cases during the week ending 17 April. There is a similar picture for healthcare workers, who accounted for 13.4% of all new cases in the second week of January 2021, compared with 3.2% of all cases during the week ending 17 April. The proportion of overall deaths arising from those aged 7 and over and also those linked to nursing home outbreaks has also fallen substantially over the period.
The Health Products Regulatory Authority is responsible for managing the national pharmacovigilance (adverse reaction reporting) system, with healthcare professionals and members of the public encouraged to submit reports of any suspected adverse reactions. All adverse reaction reports received are individually assessed, with relevant follow up information requested as appropriate and reports entered into the HPRA’s national pharmacovigilance database. These reports are subsequently sent to EudraVigilance (EV), the European Medicines Agency’s (EMA’s) database of suspected adverse reactions, where the data are analysed to detect new safety signals. Monitoring of suspected adverse reactions is an important part of the EMA’s intensive monitoring plan for COVID-19 vaccines, so that any changes in benefit risk balance can be promptly detected and acted upon. This enables the EMA to continue to safeguard public health safety.
The HPRA cautions against attributing suspected side effects occurring after vaccination on the basis of temporal association alone, given the well-established limitations of spontaneous reports. The totality of data from all sources (e.g. clinical and epidemiological studies and literature) must be considered as part of ongoing safety monitoring to ensure evidenced based conclusions are drawn.
The HPRA publish regular safety update reports which provide an overview of national reporting experience with COVID-19 vaccines as well as key information arising from EMA reviews of worldwide safety data. To date, five safety updates have been published. The most recent published on 25 March reported that the HPRA had received 31 reports describing patients who passed away in the days or weeks following vaccination with authorised COVID-19 vaccines. The majority of these have been reported in association with mRNA vaccines. The reports mainly describe fatalities which are regularly seen due to natural causes or progression of underlying disease. In all cases, the patients concerned had underlying conditions and/or concurrent illness, with a small number having tested positive for COVID-19. All reports are being carefully reviewed. However, it can be expected that fatalities due to progression of underlying disease or natural causes will continue to occur, including following vaccination. The HPRA states that this does not mean that the vaccine caused the deaths.
The HPRA also participate in EMA coordinated reviews of worldwide safety data for COVID-19 vaccines. The EMA’s Safety Committee, the PRAC, reviews safety issues during monthly plenary meetings, the highlights of which are published. After careful review of these data, none of the reviews to date have identified a safety concern from cumulative analysis of reports of fatalities from all causes. In most cases, progression of (multiple) pre-existing diseases was considered a plausible explanation. The WHO Global Advisory Committee on Vaccine Safety (GACVS) has also reviewed available data on fatalities and concluded that current reports do not suggest any unexpected or untoward increase in fatalities in frail, elderly individuals. Similar conclusions have been reached by other agencies responsible for safety monitoring, including in the US and the UK.
Legally, in Ireland, a death can be registered with the General Registrar’s Office (GRO) up to three months after the date of occurrence and in practice some deaths may be registered considerably later (See www.gov.ie/en/service/49c66f-registering-a-death-in-ireland/). A public consultation has recently been concluded by the Department of Social Protection on the process for notifying and registering deaths in Ireland with the aim of reducing the time period for registering a death and the results of the consultation are currently being reviewed by that Department. All COVID-19 deaths are reportable to the Coroner.
While the majority of COVID-19 related deaths are notified in a timely manner, in some instances, notification of a death may be delayed. The daily Department of Health Press Release includes all additional deaths that have been newly notified to it by the Health Protection Surveillance Centre (HPSC), regardless of the date of occurrence. The HPSC is Ireland's specialist agency for the surveillance of communicable diseases. As of February 2020, COVID-19 was added to the existing list of notifiable diseases. HPSC receives information regarding deaths from a number of sources. Its primary source of information is the national infectious disease surveillance system (CIDR).
CIDR is populated by data from eight regional Departments of Public Health (DPHs). Staff in regional DPHs populate CIDR data regarding deaths, either directly from clinical information they receive when investigating cases and outbreaks of COVID-19 or from Coroner’s files that they receive on a regular basis. HPSC may also receive Coroner’s files to cross reference with regional DPH data. In addition, HPSC receives a daily file from the General Registrar’s Office (GRO) as an additional source of data regarding COVID-19 deaths.
1754. Deputy Ged Nash asked the Minister for Health the names of the security firms carrying out the security related work in respect of the Covid-19 mandatory hotel quarantine regulation; if security staff contracted to support the mandatory hotel quarantine system are in full compliance with the terms of the current security employment regulation order including the minimum hourly rate of pay; and if he will make a statement on the matter. [18895/21]
View answerThe Mandatory Hotel Quarantine service provider is required to provide a private security authority (“PSA”) licenced contractor to be always present at their Designated Facilities.
The service provider must ensure that all personnel who carry out a security function comply with the licensing requirements of the Private Security Authority and must comply with the Private Security Services Act 2004. The licensed private security contractor will have 24/7 on-site presence at each designated facility.
The private security services are required to ensure that guests adhere to all infection prevention and control protocols during their stay, and to ensure access to the hotel is controlled, and security staff have been given training in this regard. Should guests attempt to leave the facility before completion of their quarantine, security personnel are required to report any such incident to the facility’s State Liaison Officer immediately and to An Garda Síochána.
The services Contractor private security staff are also present during transportation of passengers to designated facilities.
1755. Deputy Maurice Quinlivan asked the Minister for Health the reason a person (details supplied) is waiting for an operation; and if he will make a statement on the matter. [18900/21]
View answerIt is recognised that waiting times for scheduled appointments and procedures have been impacted in the last year as a direct result of the COVID-19 pandemic.
The HSE is currently recommending that only critical time dependent elective procedures are undertaken at this time due to the on-going and significant increased demand for bed capacity related to COVID-19.
This decision was made arising from the rapid increase in COVID-19 admissions and to ensure patient safety and that all appropriate resources were made available for COVID-19 related activity and time-critical essential work.
Patient safety remains at the centre of all hospital activity and elective care scheduling. To ensure services are provided in a safe, clinically-aligned and prioritised way, hospitals are following HSE clinical guidelines and protocols.
On 23 March the HSE published the “Safe Return to Health Services Plan”. This plan outlines a three phased approach for the proposed restoration of services across Community Services, Acute Hospital Operations, Cancer Services and Screening Services. It sets target times for their safe return and details the conditions and challenges that will have to be met.
Every phase of the plan has been informed by clinical guidance and putting patient and staff safety first.
Decisions in relation to the type and volume of activity will be made at site level based on local COVID-19 numbers, available capacity and guidance from national clinical leads.
The schedule outlined in the plan for resumption of services will be regularly monitored by the HSE and updated as appropriate, dependant on public health advice and healthcare capacity.
Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
The National Waiting List Management Policy is a standardised approach used by the HSE to manage scheduled care treatment for in-patient, day case and planned procedures. It sets out the processes that hospitals are to implement to manage waiting lists and was developed in 2014 to ensure that all administrative, managerial and clinical staff follow an agreed national minimum standard for the management and administration of waiting lists for scheduled care.
In relation to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1756. Deputy Mattie McGrath asked the Minister for Health if he will immediately reconsider easing restrictions on outdoor gatherings, outdoor activities and outdoor hospitality services in view of the recent data from the HSPC on the low incidence rates from outdoor gathering; and if he will make a statement on the matter. [18902/21]
View answer1958. Deputy Alan Farrell asked the Minister for Health the considerations his Department is giving to easing restrictions on inter-household gatherings outdoors following recently published figures from the Health Protection Surveillance Centre showing significantly less transmission of Covid-19 in outdoor settings; and if he will make a statement on the matter. [19429/21]
View answer1959. Deputy Alan Farrell asked the Minister for Health the considerations his Department is giving to easing restrictions relating to businesses with outdoor facilities following recently published figures from the Health Protection Surveillance Centre showing significantly less transmission of Covid-19 in outdoor settings; and if he will make a statement on the matter. [19430/21]
View answerI propose to take Questions Nos. 1756, 1958 and 1959 toegether.
NPHET has consistently advised that outdoor settings are considerably safer than indoor ones based on national and international evidence. This was a key informing principle in the development of the 5 level framework of public health measures last September and in the Government decision last month to commence the easing of some measures over April which are focused specifically on outdoor activities. As the Deputies will be aware, households have been permitted to meet with one other household outdoors for social or recreational purposes since the 12 April. From 19 April, adult inter-county GAA training can commence while from the 26 April, outdoor sports facilities and outdoor visitor attractions will reopen and underage non-contact outdoor training will also resume.
The situation will be subject to ongoing review taking account of the evolving epidemiological situation, the impact of the reopening of priority services, and available evidence in relation to vaccine deployment, uptake and effectiveness. The NPHET and the Government will consider the position again at the end of this month and it is anticipated that a roadmap for the further easing of measures over the coming months will be agreed.
It is important to note, however, that while outdoors is safer, it is not risk-free. It is important to continue to practice social distancing and other safe behaviours when meeting people outdoors and masks should be worn in crowded outdoor spaces.
HIQA undertook an evidence review on higher-risk environments and activities for the NPHET in November 2020, drawing on national and international evidence. The Review found that while there is consistent evidence that the risk of outdoor transmission of COVID-19 is substantially lower, there is still evidence of transmission occurring in outdoor environments. This is particularly the case when there are large gatherings, where social distancing or the use of face coverings are neglected, and where there is dense congregation and mixing among groups. There are also risks linked to what might precede and follow outdoor gatherings including associated events and activities and shared travel to or from events or activities. The review is available here.
(www.hiqa.ie/reports-and-publications/health-technology-assessment/activities-or-settings-associated-higher-risk.)
In relation to the data published by the HPSC, the HSE has clarified that this data is limited and will not reflect all cases associated with outside activities. Firstly, it only relates to outbreak data and it is not possible to link every case to a particular outbreak setting. A proportion of cases will also be considered community transmission or are under investigation when the source isn’t known. As such, the surveillance data would not capture all cases potentially associated with an outdoor environment/activity. Secondly, there may be outbreak settings that wouldn’t be considered as “outdoor” environments but where transmission amongst some cases associated with such outbreaks may have occurred outside (e.g. while congregating/socially interacting outside a building and not maintaining physical distancing etc.). Thirdly, there are indoor ancillary activities associated with outdoor activities as set out above (eg travel to/from activity, changing rooms etc.) that won’t be classified as linked to an outdoor event.
1757. Deputy Mick Barry asked the Minister for Health if he will set up a real time suicide data programme on a national basis; and if he will make a statement on the matter. [18905/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
1758. Deputy Mick Barry asked the Minister for Health the steps he will take to increase the uptake of the HPV vaccine; the steps he will take to make the vaccine available to persons that did not take it up in 2020; and if he will make a statement on the matter. [18906/21]
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 continues to revise recommendations to allow for the introduction of new vaccines in Ireland and to keep abreast of changes in the patterns of disease. Therefore, the immunisation schedule will continue to be amended over time.
In 2009, the NIAC recommended HPV (human papillomavirus) vaccination for all 12 to 13 year old girls to reduce their risk of developing cervical cancer when they are adults. In September 2010, the HPV vaccination programme was introduced for all girls in first year of secondary school.
The NIAC recommended that the HPV vaccine should also be given to boys. On foot of the NIAC’s recommendation, my Department asked the Health Information and Quality Authority (HIQA) to undertake a health technology assessment (HTA) to establish the clinical and cost-effectiveness of extending the current immunisation programme to include boys in the first year of secondary school.
The HIQA completed the HTA in December 2018, recommending that the HPV immunisation programme be extended to include boys. A policy decision was made to extend the HPV immunisation programme to include boys, starting in September 2019, with the introduction of a 9-valent HPV vaccine.
The ages at which vaccines are recommended in the immunisation schedule are chosen by the NIAC in order to give each child the best possible protection against vaccine preventable diseases. As the HPV vaccine is preventative it is intended to be administered, if possible, before a person becomes sexually active, that is, before a person is first exposed to HPV infection.
Therefore, the gender-neutral HPV vaccination programme targets all girls and boys in first year of secondary school to provide maximum coverage. All vaccines administered through the School Immunisation Programme are provided free of charge.
My Department will continue to be guided by NIAC's recommendations on any emerging evidence on this issue in the future.
Anyone not in 1st year of secondary school or age equivalent in special schools or home schooled during the 2020/2021 school year who wishes to get the HPV vaccine, must go to their GP or sexual health clinic and pay privately for the vaccine and its administration.
It is important to note that the schools-based immunisation programme for the 2019/2020 academic year has been completed and the uptake rates for the HPV vaccine in that academic year are 82% for the first dose of the vaccine and 77% for the second dose.
The uptake rate for the first dose of the HPV vaccine in the 2020/2021 academic year, as at the 15 of April, is 63% and this figure is expected to increase because data input on vaccine uptake is ongoing.
1759. Deputy Mick Barry asked the Minister for Health the provision he plans to make for persons in mandatory hotel quarantine that have a need to provide care for children or others; and if he will make a statement on the matter. [18907/21]
View answerThe Health Act 1947, as amended, provides that all persons arriving in Ireland from a designated state, or having travelled through a designated state in the previous 14 days, are required to undergo mandatory quarantine in a designated facility unless they are an exempted traveller under the Act.
The safety, wellbeing and comfort of all guests quarantining in a designated facility is a priority of the mandatory quarantine system, along with the ultimate goal of protecting public health by limiting the potential spread of COVID-19 variants of concern.
All facilities in the mandatory quarantine system have a designated outdoor area on-site which guests will be allowed to use on a scheduled basis up to three times daily, subject to their having received a 'not detected' result in their initial RT-PCR test. Additional time will be available to families with children should they request it.
All guests undergoing mandatory quarantine in a designated facility are being provided with access to a 24/7 on-site healthcare team who hold clinical responsibility for their wellbeing during their stay. The on-site healthcare team are available to address any wellbeing concerns of guests through both scheduled daily check-in calls during a guest's stay as well as through direct engagement if requested. Guests requiring any specific, urgent or emergency care which cannot be provided on-site at a hotel may also be referred to a dedicated medical facility by the on-site healthcare team.
Guests who wish to access other services, such as online education services, may arrange to do so through normal channels. The hotel service provider will endeavour to facilitate any requests for assistance in accessing such channels.
The State Liaison Officer (SLO) will have staff onsite 24/7 at each designated facility to liaise between guests and the service provider if required.
All reasonable efforts will be made by both service provider staff and the on-site health team to facilitate a comfortable stay in a designated facility.
No provision exists in the Health Act 1947 as amended, nor the design of the mandatory quarantine system for the provision of care of persons outside of the mandatory quarantine system. Any such required support should be accessed through usual channels.
1760. Deputy Mick Barry asked the Minister for Health the budget allocated for the provision of mandatory Covid-19 detention facilities; and if he will make a statement on the matter. [18908/21]
View answerMandatory Hotel Quarantine has been introduced with the aim of protecting Ireland from the importation of COVID-19, particularly Variants of Concern. As Minister I am committed to protecting public health as a matter of urgency, and my Department continues to work with all State stakeholders and with Tifco Hotel Group to implement this policy, and to ensure that those who enter Mandatory Hotel Quarantine are comfortable and secure as they comply with the public health advice for all of our benefit.
On awarding of the contract with the service provider, a cost model was developed which sees travellers pre-booking and pre-paying to cover the cost of all services required as part of their stay in mandatory quarantine. There are certain fixed costs in relation to standing up and operating the system which have been established in the contract, and must be paid by the Department. A table of charges was agreed based on how many hotel facilities are brought in or out of use, and those terms of the contract remain commercially sensitive.
1761. Deputy Mick Barry asked the Minister for Health the number of persons that have entered mandatory Covid-19 detention facilities since its commencement; the number that have been due to the failure to provide a PCR test result; the number that have had positive results upon testing in the detention facilities; and if he will make a statement on the matter. [18909/21]
View answerAs of Thursday 15 of April:
- a total of 416 guests have completed mandatory quarantine in a designated facility and a further 478 guests were in a designated facility at that time.
- 97 guests have attended a designated facility due to lack of negative RT-PCR test upon arrival in the state.
- There have been 19 Covid-19 detected cases in guests undergoing quarantine in a designated facility.
