Wednesday, 14 Jul 2021

Departmental Expenditure

Questions (324)

Carol Nolan

Question:

324. Deputy Carol Nolan asked the Minister for Health the details of the expenditure incurred by staff in his Department under the heading of travel and subsistence from 1 January 2020 to date; and if he will make a statement on the matter. [30919/21]

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Written answers

Minister for Health

Details of travel and subsistence spend in my Department for the period of 1 January 2020 to 30 June 2021 is set out in the table below:

	2021 (1 January-30 June)	2020
Home travel	€35,420.52	€104,225.23
EU travel	€679.90	€66,071.45
Non-EU travel	€865.35	€34,586.54
	€36,965.77	€204,883.22

Departmental Inquiries

Questions (325)

Carol Nolan

Question:

325. Deputy Carol Nolan asked the Minister for Health the details of each value for money and policy review conducted by his Department from 1 January 2019 to date; if external costs were incurred; if so, the details of such costs; and if he will make a statement on the matter. [30920/21]

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Written answers

Minister for Health

Since 2019 the Department of Health has conducted one value for money and policy review, a Value for Money and Policy Review on Nursing Home Care Costs, which has been completed and is due to be published shortly.

A study on the care needs of residents in nursing homes was carried out as part of this review using the InterRAI Assessment Tool. The InterRAI software and associated training required to carry out the study was purchased from Oy Raisoft Ltd at a cost of €15,836.25, inclusive of VAT. No other external costs were incurred.

Vaccination Programme

Questions (326, 341)

John Lahart

Question:

326. Deputy John Lahart asked the Minister for Health the reason that mandatory hotel quarantine is required for a WHO approved vaccine (details supplied); and if he will make a statement on the matter. [30921/21]

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Paul Murphy

Question:

341. Deputy Paul Murphy asked the Minister for Health the reason mandatory hotel quarantine is required for a WHO approved vaccine when there is no liability in the event of side effects as the State has not supplied a vaccine (details supplied); and his views on whether the State’s concern should be with the performance of the vaccine which has received WHO acceptance. [30967/21]

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Written answers

Minister for Health

I propose to take Questions Nos. 326 and 341 together.

Ireland procures COVID-19 vaccines through its participation in an EU procurement process and their approval is by the Commission following recommendation by the EMA.

At present, the Sinopharm vaccine has not received EMA approval.

COVID-19 vaccines can only be approved and used if they comply with all the requirements of quality, safety and efficacy set out in the EU pharmaceutical legislation. No vaccine will be used until Market authorisation from the European Medicines Agency (EMA) is obtained and any authorised vaccine will be subject to ongoing monitoring in Ireland by the Health Product Regulatory Authority (HPRA).

Passengers who are fully vaccinated in accordance with the table below and have the documents to confirm this are not required to complete mandatory hotel quarantine on arrival in Ireland. Dependents, including children, will also be exempted from the requirement to complete mandatory hotel quarantine.

What 'fully vaccinated' means:

A full course of any one of the following vaccines	Regarded as fully vaccinated after:
2 doses of Pfizer-BioNtech Vaccine: BNT162b2 (Comirnaty®)	7 days
2 doses of Moderna Vaccine: CX-024414 (Moderna®)	14 days
2 doses of Oxford-AstraZeneca Vaccine: ChAdOx1-SARS-COV-2 (Vaxzevria® or Covishield)	15 days
1 dose of Johnson & Johnson/Janssen Vaccine: Ad26.COV2-S [recombinant] (Janssen®)	14 days

Mental Health Services

Questions (327)

Mark Ward

Question:

327. Deputy Mark Ward asked the Minister for Health if a person who lives outside of the CHO areas chosen for pilot sites in relation to the model of care adults accessing talk therapies will have access to the programme; if not, the reason; and if he will make a statement on the matter. [30953/21]

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Written answers

Minister of State at the Department of 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.

General Practitioner Services

Questions (328)

Brendan Griffin

Question:

328. Deputy Brendan Griffin asked the Minister for Health when out-of-hours general practitioner services will resume at a location (details supplied) in County Kerry; and if he will make a statement on the matter. [30954/21]

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Written answers

Minister for Health

In response to the COVID-19 public health emergency, certain SouthDoc GP out-of-hours treatment centres were closed by the Board of Directors of SouthDoc to help limit the possible spread of Covid-19. All treatment centres in County Kerry have since reopened, the last centre to reopen being the Listowel treatment centre.

Since Monday 5th July, Listowel related calls to SouthDoc are being processed through the Listowel treatment centre where they are being clinically assessed by an onsite doctor for each out-of-hours session seven days a week. Prior to that date patients were seen at the centre on a scheduled appointment basis. The type and nature of treatment is decided in the normal way based on the clinical needs of each patient.

The Board of Directors of SouthDoc will continue to monitor the demand for the service and should there be an increase in the patients accessing the service they may review the current level of service to ensure the appropriate service is available.

Dental Services

Questions (329)

Kathleen Funchion

Question:

329. Deputy Kathleen Funchion asked the Minister for Health if his attention has been drawn to the fact that dentists in County Carlow are not accepting medical cards; and if he will make a statement on the matter. [30955/21]

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Written answers

Minister for Health

The Dental Treatment Services Scheme (DTSS) provides dental care, free of charge to medical card holders aged 16 and over. These services are provided by independent dental practitioners who have a contract with the HSE. Patients may choose to have their treatment undertaken by any dentist who participates in the Scheme.

I am aware that there has been a reduction in the numbers of dentists participating in the DTSS since the beginning of the current COVID-19 pandemic. Some people are experiencing problems in accessing a service close to their home. However, I have been assured by the HSE that their local services on the ground will assist any persons who are experiencing problems in accessing a service.

The national approach to future oral health service provision will be informed by Smile agus Sláinte, the National Oral Health Policy, which was published in 2019. The aim of the policy is to develop a model of care that will enable preventative approaches to be prioritised, improve access, and support interventions appropriate to current and future oral health needs.

I am committed to ensuring the sustainability and viability of the DTSS, which will need to be revised to align it with modern evidence and the aims of the new Policy. There was an intention to commence a review of the DTSS contract last year. Unfortunately, due to the pandemic, this was not possible. Officials in my Department are currently engaging with the Irish Dental Association to commence this process.

Covid-19 Tests

Questions (330)

Seán Haughey

Question:

330. Deputy Seán Haughey asked the Minister for Health the reason that private PCR tests are required for international travel after 19 July 2021; if HSE Covid-19 tests can be used for the purposes of international travel from this date; and if he will make a statement on the matter. [30956/21]

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Written answers

Minister for Health

Under the current measures, travellers arriving into Ireland from overseas are required to present evidence of a negative / non-detected pre-departure RT-PCR test taken within 72 hours of arrival. New measures applying to passengers travelling to the State are intended to be introduced from 19th July, subject to prevailing public health situation.

Travellers leaving the State will have to meet the requirements of their destination country and may access testing via private testing providers.

It will be possible for a Digital COVID Certificate, in respect of negative test results, to be provided by private testing services. The testing capacity of the HSE is prioritised for public screening and testing of higher risk groups.

Cross-Border Co-operation

Questions (331)

Neasa Hourigan

Question:

331. Deputy Neasa Hourigan asked the Minister for Health the number of persons who availed of the cross-border directive scheme in 2018, 2019 and 2020 respectively; and if those availing of the scheme did so in the United Kingdom or the rest of the European Union, respectively. [30957/21]

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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, given the recent cyber-attack, which has required a temporary shut-down of HSE IT systems, 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. However, the HSE has been able to supply the following information regarding the CBD.

Table 1:

-	Year	Year	Year
Activity Description	2018	2019	2020
Activity Description	2018	2019	2020
No. of CBD reimbursements Approved	3,886	4,961	4,723

Note: It should be noted that the CBD office records application statistics, however, one patient may have, and indeed is likely to have more than one application and likewise one patient may equally have one application but several episodes of care abroad. The CBD records reimbursements in respect of episodes of care. Therefore this data relates to reimbursements and not to number of patients. For example one patient may submit numerous claims for reimbursement e.g. a consultation, a surgery and follow up care.

Table 2:

Countries of Treatment:

2018	2019	2020
UK	UK	UK
Poland	Poland	Poland
Lithuania	Lithuania	Lithuania
Germany	Germany	Spain
Czech Republic	Spain	Germany
France	Netherlands	Latvia
Hungary	Belgium	Belgium
Spain	Latvia	Czech Republic
Latvia	Portugal	Romania
Estonia	France	Hungary
Netherlands	Hungary	Portugal
Italy	Italy	Slovakia
Slovakia	Other	Norway
Other		Italy

Healthcare Policy

Questions (332)

Paul Murphy

Question:

332. Deputy Paul Murphy asked the Minister for Health if he plans to extend the community ophthalmic services scheme for those over 12 years of age, beyond medical card holders and their dependants to include students in secondary school for the dispensing of spectacles and optical devices given that glasses are a necessity and are not for cosmetic reasons. [30958/21]

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Written answers

Minister for Health

Sight testing, eye examinations and optical appliances are provided to medical card holders by ophthalmologists, optometrists and dispensing opticians through the Community Ophthalmic Services Schemes (COSS). Patients may access these services following a referral by a healthcare professional such as their general practitioner. The reimbursement of the cost of eye tests and glasses for all children is administered by the HSE Primary Care Reimbursement Service.

There are currently no plans to extend eyecare services to children over 12 years of age who are not covered by a medical card.

All children, including those not covered by a medical card, receive a vision screen while in national school from a Public Health Nurse. The HSE provides optical services free of charge to pre-school children and national school children referred from child health service and school health service examinations who are discovered to have sight problems. These children are referred to the appropriate consultant for treatment. In such circumstances, these services will continue to be provided until the child has reached the age of 16.

The HSE Primary Care Eye Services Review Group (PCESRG) Report was launched in June 2017. The Report sets out current levels of service, models of service provision and the consultation process undertaken with patients, advocates, ophthalmic staff and representative bodies. It also highlights the limitations of the current model of service delivery and sets out the way forward for a significant amount of eye services to be delivered in a primary care setting. The Report estimates that 60% of existing outpatient activity could be moved to primary care thus enabling hospital services to focus on patients who require more specialist diagnostics or treatments.

The National Clinical Programme for Ophthalmology has developed a model of care which details how the realignment of eye services from the acute hospitals to the community will be undertaken. The recommendations from the PCESRG Report also complement the Model of Care.

The Primary Care Eye Services Review Group Report remains current and the HSE is implementing a number of measures. Included in current priorities is transferring the care of children aged 8+ years to the care of local private optometrists, creating a new role of Consultant Medical Ophthalmologist, and recruiting additional Consultant Medical Ophthalmologists to other CHOs.

Assisted Human Reproduction

Questions (333)

Neale Richmond

Question:

333. Deputy Neale Richmond asked the Minister for Health if he will initiate an amendment to the Children and Family Relationships Act 2015 such that parentage shall be assigned to both parties in circumstances in which a donor-assisted human reproduction procedure has been performed outside the State; if his attention has been drawn to the number of same-sex parents who cannot have their name registered as parents of their own child in Ireland simply due to the fact that the procedures were carried out outside of the State; his views on whether this is treating one family differently to another and requires change; and if he will make a statement on the matter. [30959/21]

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Written answers

Minister for Health

Parts 2 and 3 of the Children and Family Relationships Act 2015 provide a legal framework for donor-assisted human reproduction (DAHR), including

the legal parentage of children born in the State as a result of DAHR procedures. Parts 2 and 3 came into operation on 4 May 2020. The provisions require consent to be signed by the intending parent or parents and the donor or donors prior to a DAHR procedure. Further, details of the procedure, including the identity of gamete and embryo donors are recorded in the National Donor Conceived Person Register. This enables the State to vindicate the rights of donor-conceived persons to information about their genetic identity.

In general, the Children and Family Relationships Act 2015 does not cover DAHR procedures that take place abroad as it is not possible to ensure that such DAHR procedures have adhered to the requirements of the Act, particularly in relation to donor conceived children's right to know their genetic heritage.

Health Service Executive

Questions (334)

Seán Fleming

Question:

334. Deputy Sean Fleming asked the Minister for Health the position regarding a project (details supplied); and if he will make a statement on the matter. [30960/21]

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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.

Medicinal Products

439. Deputy Patrick Costello asked the Minister for Health the status of the availability of the drug zolgensma in the State; and if he will make a statement on the matter. [31596/21]

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Written answers

Minister for Health

I propose to take Questions Nos. 335, 342, 345, 363, 367, 377, 379, 381 to 384, inclusive, 387, 400, 402, 404, 415, 422, 427, 431, 433 and 439 together.

The HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drugs schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.

In line with the 2013 Health Act and the national framework agreed with industry, if a company would like a medicine to be reimbursed by the HSE, the company must submit an application to the HSE to have the new medicine added to the reimbursement list. Reimbursement is for licensed indications which have been granted market authorisation by the European Medicines Agency or the Health Products Regulatory Authority.

In making a relevant reimbursement decision, the HSE is required under the Act to have regard to a number of criteria, including efficacy, the health needs of the public, cost effectiveness and potential or actual budget impact.

HSE decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds, on the advice of the National Centre for Pharmacoeconomics (NCPE).

I am advised by the HSE that, in April 2020, the NCPE received a reimbursement application dossier for Onasemnogene abeparvovec (Zolgensma). On 13 May 2020, the NCPE completed a rapid review with respect to this application and recommended a full Health Technology Assessment (HTA) to assess the clinical effectiveness and cost effectiveness of Zolgensma compared with the current standard of care.

The HTA was undertaken as a part of the Beneluxa collaboration between Ireland, the Netherlands and Belgium, with Austria acting as a reviewer in the Belgian procedure.

The HTA was completed in May 2021 and an assessment summary is available on the NCPE's website. At the conclusion of this HTA, the NCPE recommended that Zolgensma not be considered for reimbursement unless cost effectiveness could be improved relative to existing treatments. Pricing/reimbursement negotiations have commenced July 2021.

A final decision on the pricing/reimbursement application for Zolgensma will be made in accordance with the 2013 Health Act.

Minister of State at the Department of 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.

Patient Transfers

Questions (339)

Brendan Griffin

Question:

339. Deputy Brendan Griffin asked the Minister for Health when a patient (details supplied) will be transferred to the National Rehabilitation Hospital, Dún Laoghaire for treatment; and if he will make a statement on the matter. [30965/21]

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Written answers

Minister of State at the Department of 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.

Health Services Staff

Questions (340)

Neasa Hourigan

Question:

340. Deputy Neasa Hourigan asked the Minister for Health the number of support staff by role such as PSA security, ushers, door staff and so on at centres (details supplied) during May 2021. [30966/21]

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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.

Question No. 341 answered with Question No. 326.

Question No. 342 answered with Question No. 335.

Mental Health Services

Questions (343)

Alan Dillon

Question:

343. Deputy Alan Dillon asked the Minister for Health the status of the implementation of the youth mental health pathfinder project; if a pathfinder national co-ordinator and regional leads are now in place; if so, the progress to date; and if he will make a statement on the matter. [31006/21]

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Written answers

Minister of State at the Department of Health

The proposal to establish a cross-governmental youth mental health Pathfinder unit, with participation from the Departments of Health, Education and Children, Equality, Disability, Integration and Youth, received Ministerial approval during the previous Government. Its establishment is a priority in the current Programme for Government.

The proposal is to formalise a new model for collaborative working within Government and place a Pathfinder unit on a statutory footing, through section 12 of the Public Service Management Act 1997. This section has not been used before. Various administrative, budgetary, governance and legal arrangements need to be developed and agreed to ensure a robust and workable model for the Pathfinder unit.

The demands on both Departments during the pandemic have presented challenges to progressing the proposals. Nonetheless, the Department of Health has engaged extensively with the Department of Public Expenditure and Reform, and continues to do so, with the objective of agreeing an implementation option that fully addresses the above issues.

Officials from the Department of Health met with officials from the Department of Public Expenditure and Reform on 8 July to discuss potential options for progress.

The implementation of the Pathfinder project is a priority for me and I will continue to keep this matter under close review in the context of progressing Sharing the Vision.

Direct Provision System

Questions (344)

Cathal Crowe

Question:

344. Deputy Cathal Crowe asked the Minister for Health if all residents in a direct provision centre (details supplied) in Meelick, County Clare have been vaccinated against Covid-19; and if he will make a statement on the matter. [31007/21]

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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.

Question No. 345 answered with Question No. 335.

Disability Services

Questions (346, 349)

Pauline Tully

Question:

346. Deputy Pauline Tully asked the Minister for Health further to Parliamentary Question Nos. 1014 and 1015 of 31 March 2021, the breakdown by specific therapy category of the 100 therapy posts that were allocated to children’s disability services under the HSE National Service Plan 2019; and if he will make a statement on the matter. [31010/21]

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Pauline Tully

Question:

349. Deputy Pauline Tully asked the Minister for Health further to Parliamentary Question Nos. 1014 and 1015 of 31 March 2021, the number of children’s disability network teams that have currently been established; and his views on whether the remaining 60 teams will be established by end Q2 2021. [31013/21]

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Written answers

Minister of State at the Department of Health

I propose to take Questions Nos. 346 and 349 together.

As these Parliamentary Questions relate to operational issues, they are 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.

Disability Services

Questions (347)

Pauline Tully

Question:

347. Deputy Pauline Tully asked the Minister for Health the whole-time equivalent therapy posts in Children’s disability services in each of the years 2018 to 2020 and to date in 2021; and if he will make a statement on the matter. [31011/21]

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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.

Disabilities Assessments

Questions (348)

Pauline Tully

Question:

348. Deputy Pauline Tully asked the Minister for Health further to Parliamentary Question Nos. 1014 and 1015 of 31 March 2021, the percentage of assessments of need that were overdue from 30 June 2020 that are now complete; if it is still anticipated that most of the CHO areas will have eliminated their assessments of need backlogs by the end of Quarter 2 2021; and if he will make a statement on the matter. [31012/21]

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Written answers

Minister of State at the Department of Health

In August 2020 the HSE secured €7.8m to address the issue of overdue Assessments of Need (AON).

This funding was provided on a once off and strictly time bound basis to eliminate all AONs overdue at 30th June 2020. While the number of overdue Assessment of Need stood at approximately 6,500 in June 2020, through a combination of different measures, by the end of April 2021 approximately 5,150 children have had their assessment completed, thus reducing the backlog to approximately 1,350 cases. An overall reduction, since the exercise began of approximately 80%. 3 CHOs have cleared their backlog, one of which has exceeded its target.

This is the latest information available from the HSE due to the recent cyber-attack, which has required a temporary shut-down of HSE IT systems.

I trust this clarifies the position for the Deputy.