Thursday, 24 Jun 2021

General Practitioner Services

Questions (416)

Verona Murphy

Question:

416. Deputy Verona Murphy asked the Minister for Health the specific provisions in place in County Wexford for private patients of retiring general practitioners who are unable to access alternative registration with general practitioner services due to the chronic lack of general practitioner capacity in County Wexford; and if he will make a statement on the matter. [26336/21]

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Written answers

Minister for Health

People who do not hold a medical card or GP visit card access GP services on a private basis and can make enquiries directly to any GP practice they wish to register with. As private contractors, it is a matter for each individual GP to decide whether to accept additional private patients. Where a GP practice has a full list of patients and cannot take on new patients, patients should contact other GP practices in the surrounding areas.

The Government is aware of the workforce issues currently facing general practice, including the limited access to GP services in certain areas, and has implemented a number of measures to improve recruitment and retention in general practice.

These measures include an increase in investment in general practice by approximately 40% (€210 million) between 2019 and 2023 under the terms of the 2019 GMS GP Agreement GP. The Agreement provides for increased support for GPs working in rural practices and for those in disadvantaged urban areas, and for improvements to maternity and paternity leave arrangements. In addition, the number of GPs entering training has been increased steadily over the past ten years, rising from 120 in 2009 to 213 in 2020, with a further increase foreseen in 2021. The ICGP noted a record number of applications for the 2021 GP training programme.

I am confident that these measures will see an increase in the number of GPs working in the State, improving access to GP services for patients throughout the country.

Vaccination Programme

Questions (417)

Thomas Pringle

Question:

417. Deputy Thomas Pringle asked the Minister for Health the status of the vaccine roll-out in County Donegal; the number of persons who have received both first and or second doses; the cohorts being vaccinated; the timeframe for completion; and if he will make a statement on the matter. [26337/21]

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Written answers

Minister for Health

As this Parliamentary Question relates to an operational issue, it is a matter for the HSE. However, members of the Oireachtas are advised that the HSE is currently unable to access the information to answer Parliamentary Questions due to the recent cyber-attack, which has required a temporary shut-down of HSE IT systems. The disruption to service is on-going, and the HSE is working hard to restore its IT capacity and resume normal services. Members of the Oireachtas will be advised as soon as the HSE is again in a position to provide responses to PQs and are encouraged to resubmit their Parliamentary Questions at that point.

Vaccination Programme

Questions (418, 429, 430, 434, 453, 460)

Thomas Pringle

Question:

418. Deputy Thomas Pringle asked the Minister for Health the reason cohort seven persons have not all been vaccinated despite other cohorts and age groups having begun their vaccinations; and if he will make a statement on the matter. [26338/21]

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Mary Lou McDonald

Question:

429. Deputy Mary Lou McDonald asked the Minister for Health if his attention has been drawn to instances in which persons who are at high risk group 7 under the age of 50 years are being advised that they must wait to register for their online Covid-19 vaccination in line with age cohort groups; if these persons are scheduled to be vaccinated as part of groups 1-7; and if he will make a statement on the matter. [26365/21]

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Mary Lou McDonald

Question:

430. Deputy Mary Lou McDonald asked the Minister for Health the way Covid-19 vaccines will be provided to persons aged 16 to 59 years who are at high risk group in cases in which their own general practitioner has opted out of providing vaccinations for this group; if impacted persons in this group will be contacted to have this information relayed to them; and if he will make a statement on the matter. [26366/21]

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Mary Lou McDonald

Question:

434. Deputy Mary Lou McDonald asked the Minister for Health the process used to identify persons who are eligible for Covid-19 vaccination aged 16 to 69 years who are at very high risk in cohort 4 and not in regular contact with a hospital or a disability service; the number who have now been identified by general practitioners; the number of persons in this group who have now been invited by their general practitioner to receive a vaccination; the number who are still awaiting an invitation to receive a vaccine from their general practitioner; and if he will make a statement on the matter. [26372/21]

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Róisín Shortall

Question:

453. Deputy Róisín Shortall asked the Minister for Health the reason that vaccination figures for cohort 7 remain low; if general practitioners or hospitals are administering vaccines to cohort 7; if all general practitioners are taking part in this phase of the roll-out; the provisions that are being made for patients in the case in which their general practitioner has not opted in for this phase; and if he will make a statement on the matter. [26530/21]

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Holly Cairns

Question:

460. Deputy Holly Cairns asked the Minister for Health the status of the delays experienced by persons in cohort 4 very high risk and cohort 7 high risk in accessing Covid-19 vaccines; and if he will make a statement on the matter. [26565/21]

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Written answers

Minister for Health

I propose to take Questions Nos. 418, 429, 430, 434, 453 and 460 together.

As this Parliamentary Question relates to an operational issue, it is a matter for the HSE. However, members of the Oireachtas are advised that the HSE is currently unable to access the information to answer Parliamentary Questions due to the recent cyber-attack, which has required a temporary shut-down of HSE IT systems. The disruption to service is on-going, and the HSE is working hard to restore its IT capacity and resume normal services. Members of the Oireachtas will be advised as soon as the HSE is again in a position to provide responses to PQs and are encouraged to resubmit their Parliamentary Questions at that point.

Health Services

Questions (419)

Rose Conway-Walsh

Question:

419. Deputy Rose Conway-Walsh asked the Minister for Health if he will provide additional detail on the majority of the funding allocated under health services in relation to the in-house research and development expenditure of the Health Research Board outlined in the most recent research and development budget; and if he will make a statement on the matter. [26339/21]

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Written answers

Minister for Health

The HRB is a statutory agency under the aegis of my Department and plays a critical role within Ireland’s research and innovation system as it sits at the interface between the higher education system and the research system. The HRB invests in data, research and evidence to deliver on the complementary objectives of improving people’s health, delivering significant transformation in health policy and practice and supporting economic and social development. The focus of HRB investment is on patient oriented and clinical research, population health sciences, and health services research.

Health research is key to achieving the objectives of the health system. It delivers knowledge, insights and evidence to address key challenges in our society. It can be used to improve the quality and efficiency of our health services and enhance the quality of life of people throughout our society. Research enables us to develop more effective preventative strategies, better health care practices and treatments, improved models of care and more efficient ways to use human, infrastructural and financial resources.

The details provided below relate to HRB returns to DBEI (Department of Business, Enterprise and Innovation) in respect of HRB expenditure (revenue and capital) for the above activities in 2019 and 2020, in line with the HRB Strategy 2016-2020. The breakdown below includes investment categorised in the report as “health services” and “other”. The “health services” figure relates to support for R&D which takes places in Irish higher education institutions, hospitals and other research performing organisations in Ireland. The smaller “other” figure relates to expenditure towards a number of EU Joint programmes. The expenditure is broken down based on the focus and enabler areas set out in the HRB Strategy (2016-2020).

Note: The total figure for 2020 below is larger than that estimated at time of submission to DBEI (by approx. €1.35M) as this reflects actual expenditure at end 2020 and includes additional investment by the HRB in support of the Government’s response to COVID-19. The Covid-19 pandemic presented a unique set of challenges to our health system, society, and economy, and required a multifaceted and agile response and the capacity to make well informed decisions in real time. The HRB responded by redirecting available funding to COVID-19 priorities and by taking on a number of additional tasks. Examples include:

- the provision of evidence reviews to inform public policy responses nationally and globally;

- funding of research projects into medical, social and policy countermeasures, health service readiness, and patient safety projects, aligned with the WHO R&D Roadmap;

- enabling Ireland’s participation in multinational clinical trials to evaluate potential treatments such as the WHO SOLIDARITY Trial;

- working with the Department and CSO to facilitate access to the CSO Covid-19 data hub for research purposes; and

- establishing a national Covid-19 research ethics committee on behalf of the Minister to expedite ethics reviews of Covid-19-related research projects.

The HRB continues to support the national and global response to COVID-19 and further details of the HRB current and planned activities can be found in the HRB Strategy (2021-2025), Health research - making an impact, which I launched earlier this (www.hrb.ie/strategy-2025).

Focus Area 1: Address major health challenges (Innovative, investigator-led and internationally competitive research to address major health challenges in society

	2019	2020
Health Research Charities Ireland (HRCI) contribution	-	297,482
Medical Research Charities Group/HRB Joint funding scheme	1,006,393	354,263
HRB Health Research Awards	2,463,722	472,254
Investigator Led Projects	4,876,649	2,055,843
SFI-HRB-Wellcome Research Partnership	1,615,569	1,737,954
US Ireland Research & Development Partnership	678,714	955,412
HRB/Wellcome Trust- Irish Clinical Academic Training Programme	250,000	400,000
HRB-IRC GenderNet Plus 2018 Award	168,666	100,000
Irish Research Nurses Network	34,523	48,966
National Children’s Hospital Foundation awards	326,628	65,861
Patrick Quinn awards for Parkinson's Research	128,021	118,020
European Joint Programme on Rare Diseases (EJPRD)	-	131,103
EU Joint Programming Initiative - Anti Microbial Resistance (AMR)	366,212	123,171
EU Joint Programming Initiative - Healthy Diet for a Healthy Life (HDHL)	220,000	155,000
EU Joint Programming Initiative – Neuro-degenerative Diseases (JPND)	463,980	434,741

Focus Area 2: Support healthcare interventions (The design, conduct and evaluation of healthcare intervention studies to improve health outcomes and health service delivery)

	2019	2020
Definitive Intervention and Feasibility Awards	4,878,186	2,843,484
European Clinical Research Infrastructure Network (ECRIN)	189,683	189,683
HRB Trials Methodology Research Network (TMRN)	72,685	336,975
Irish Clinical Oncology Research Group (ICORG)	3,184,913	3,561,620
WHO-SOLIDARITY Trial (Covid-19 treatments)	-	1,400,000
Clinical Research Co-ordination Ireland (CRCI)	159,543	1,081,780
Clinical Trials Research Networks	1,542,342	665,581

Focus Area 3: Address the research needs of the Irish health and social care system (Partnership-driven research, information and evidence that meet the needs of the Irish health and social care system)

	2019	2020
All Ireland Institute of Hospice and Palliative Care Structured Research Network	70,000	66,614
Applied Partnership Awards	1,277,278	847,718
Applied Research Projects in Dementia	101,639	-
Capacity Building for Evidence Synthesis/Cochrane Fellowships	584,540	796,391
Collaborative Applied Research Grants	114,490	-
Covid 19 - Rapid Response Call	-	4,507,775
Dementia and Neurodegeneration Network Ireland	71,670	81,620
Evaluation of the Pilot Implementation of the Framework for Safe Nurse Staffing and Skill Mix	291,653	179,544
Health Research Awards/Knowledge Exchange and Dissemination	156,535	173,484
HRB Collaboration in Ireland for Clinical Effectiveness Reviews	502,886	468,729
Research Collaborative for Quality & Patient Safety	501,899	609,879
Secondary Data Analysis Projects	-	108,135
The Irish Longitudinal Study of Ageing (TILDA)	-	3,088,967
HRB Health Research Centres	521,643	487,696
The Irish Longitudinal Study on Ageing: Intellectual Disability Supplement	478,266	571,865

Enabler A: Support exceptional researchers and leaders (Support the exceptional researchers, talent and leadership we need to undertake high-quality health research and generate evidence)

	2019	2020
HRB Research Leaders Awards & Clinician Scientist Awards	2,101,618	2,254,962
Structured Population & Health Research Education (SPHeRE)/PhD Scholars Programmes	1,209,861	972,584
Applying Research into Policy & Practice Postdoctoral Fellowships	355,422	404,733
Cancer Nursing Research - Project Development Grant	10,000	-
Clinician Scientist Postdoctoral Fellowship		438,615
Emerging Investigator Awards	2,106,400	2,605,793
Fulbright Awards	30,000	29,727
Health Professional Fellowships	549,152	235,719
HRB Internship Programme	86,679	285,028
HRB/NCI Cancer Prevention Fellowship Programme	23,104	-
Interdisciplinary Capacity Enhancement Awards	474,570	213,612
Emerging Clinician Scientist Awards	-	762,300
Collaborative Doctoral Awards	-	1,789,258
Ulysses Awards	10,000	-
HRB IMPACT Awards	-	15,585
National Cancer Control Programme Training	8,322	-
National Specialist Registrar/Senior Registrar Fellowship Academic Programme	5,063	74,756
NCI Summer Curriculum in Cancer Prevention	23,695	-
Summer Student Scholarships	187,200	61,800

Enabler B: Build a strong enabling environment (Build a strong enabling environment for health research in Ireland)

	2019	2020
Clinical Research Facilities	2,198,669	2,754,453
Proof of Concept Technical Model for Data Access, Storage, Sharing and Linkage (DASSL)	184,416	185,584
Irish Platform for Patient Organisations, Science and Industry (IPPOSI) contribution	75,000	75,000
Public Patient Involvement-Ignite Award	235,571	638,157

Health Services Staff

National Maternity Hospital

Questions (425)

Neale Richmond

Question:

425. Deputy Neale Richmond asked the Minister for Health if the new maternity hospital in the grounds of St. Vincent’s Hospital will have any involvement of a charity (details supplied); if the maternity hospital will retain its independence; the steps he is taking to ensure this; and if he will make a statement on the matter. [26345/21]

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Written answers

Minister for Health

The Government is committed to the development of the new National Maternity Hospital (NMH) planned for the St Vincent’s University Hospital Campus at Elm Park, as set out in the Programme for Government. Significant progress has been made on the capital project, with planning permission for the hospital secured in 2017 and, in 2018, the awarding of contract for substantial enabling works.

The ownership and governance arrangements are more complex. The proposed corporate and clinical governance arrangements for the new NMH at Elm Park were set out in the Mulvey Agreement, which was finalised in 2016 following an extensive mediation process between the NMH and the St. Vincent’s Healthcare Group, published thereafter and noted by Government in 2017. The Mulvey Agreement provides for the establishment of a new company - National Maternity Hospital at Elm Park DAC - which will have clinical and operational, as well as financial and budgetary, independence in the provision of maternity, gynaecology and neonatal services.

The draft legal framework subsequently developed is designed to copperfasten these arrangements. It provides that the new hospital remains in State ownership and that thus, the State’s significant investment will be protected. The clear legal advice provided to the State is that the draft legal framework ensures that all legally permissible medical services will be provided in the new hospital. The Sisters of Charity will not play any role in the governance or operation of the new NMH. In May 2017, the Sisters announced their decision to end their involvement and transfer their shareholding in SVHG to a new charitable entity, St Vincent’s Holdings CLG.

We will continue to examine all options carefully as we move forward towards finalisation of the arrangements. I have been very clear that I will not bring anything to Government unless it provides assurances around all legally permissible services being provided in the new NMH. In addition, the safeguarding of the State’s investment must also be put beyond doubt.

In that context, I intend to engage further with both St Vincent’s Healthcare Group and the Religious Sisters of Charity over the coming days and weeks.

General Practitioner Services

Questions (426)

Brendan Griffin

Question:

426. Deputy Brendan Griffin asked the Minister for Health if he will address a matter (details supplied) regarding general practitioners charging to take blood; and if he will make a statement on the matter. [26347/21]

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Written answers

Minister for Health

There is no provision under the GMS GP contract for persons who hold a medical card or GP visit card to be charged for routine phlebotomy services provided by their GP which are required to either assist in the diagnosis of illness or the treatment of a condition. This has been advised to GPs by the HSE.

The issue of GPs charging GMS patients for phlebotomy services is complex given the numerous reasons and circumstances under which blood tests are taken. My Department and the HSE discussed this issue previously with the relevant GP representative body. However, it did not prove possible to achieve agreement that no charges for blood tests would be applied in any circumstances. It is intended to raise this issue again at an appropriate time.

It should be noted that the GP chronic disease management programme which is being phased in, having commenced last year, will involve the ongoing monitoring of patients’ condition and any blood tests required in this context will be covered by the fees payable for this care.

In addition, the position remains that where a patient who holds a medical card or GP visit card believes he or she has been incorrectly charged for routine phlebotomy services by his or her GP, then that patient should report the matter to their HSE Local Health Office. The local management, upon being notified of potential inappropriate charging of GMS patients, carry out an investigation into each complaint and will, where appropriate, arrange for a refund of charges incorrectly applied by the GP.

Vaccination Programme

Questions (427)

Mary Lou McDonald

Question:

427. Deputy Mary Lou McDonald asked the Minister for Health the number of persons that have been identified as eligible for Covid-19 vaccination aged 16 to 59 years who are at high risk group 7; the number of persons in this group that have been invited by their general practitioner to receive a vaccine; and the number of persons in this group that are still awaiting an invitation from their general practitioner. [26363/21]

View answer

Written answers

Minister for Health

As this Parliamentary Question relates to an operational issue, it is a matter for the HSE. However, members of the Oireachtas are advised that the HSE is currently unable to access the information to answer Parliamentary Questions due to the recent cyber-attack, which has required a temporary shut-down of HSE IT systems. The disruption to service is on-going, and the HSE is working hard to restore its IT capacity and resume normal services. Members of the Oireachtas will be advised as soon as the HSE is again in a position to provide responses to PQs and are encouraged to resubmit their Parliamentary Questions at that point.

Vaccination Programme

Questions (428)

Mary Lou McDonald

Question:

428. Deputy Mary Lou McDonald asked the Minister for Health the guidelines that have been provided to general practitioners to identify persons who are eligible for Covid-19 vaccination aged 16 to 59 years who are at high risk cohort 7; and if he will make a statement on the matter. [26364/21]

View answer

Written answers

Minister for Health

As this Parliamentary Question relates to an operational issue, it is a matter for the HSE. However, members of the Oireachtas are advised that the HSE is currently unable to access the information to answer Parliamentary Questions due to the recent cyber-attack, which has required a temporary shut-down of HSE IT systems. The disruption to service is on-going, and the HSE is working hard to restore its IT capacity and resume normal services. Members of the Oireachtas will be advised as soon as the HSE is again in a position to provide responses to PQs and are encouraged to resubmit their Parliamentary Questions at that point.

Question No. 429 answered with Question No. 418.

Question No. 430 answered with Question No. 418.