Written Answers Nos. 2228-2247
2228. Deputy Kieran O'Donnell asked the Minister for Health when the three whole-time equivalent dietitian posts announced in January 2021 will be recruited as part of winter plan will commence their posts in University of Limerick Hospital adult diabetes services; and the portion of these posts that are assigned to adult diabetes care in the acute services in Limerick, Ennis and Nenagh diabetes clinics. [37075/21]
View answerAs 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.
2229. Deputy Kieran O'Donnell asked the Minister for Health the number of persons with diabetes over the age of 18 years attending University of Limerick Hospitals Groups' adult diabetes service who are using insulin pump therapy to manage their condition. [37076/21]
View answerAs 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.
2230. Deputy Kieran O'Donnell asked the Minister for Health the number of persons with diabetes who are waiting on a first appointment to the outpatient's diabetes clinic in University of Limerick Hospitals group; and the number who are waiting over 12, 24 and 36 months, over 4 and 5 years in tabular form. [37077/21]
View answerAs 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.
2231. Deputy Kieran O'Donnell asked the Minister for Health when the University of Limerick Hospitals' adult diabetes service will have the level of staffing (details supplied) required to initiate the dose adjustment for normal eating structured education course aimed to help adults with type 1 diabetes lead as normal a life as possible whilst also maintaining blood glucose levels within healthy targets to reduce the risk of long-term diabetes complications; and when dose adjustment for normal eating will be operational in University of Limerick Hospital for adults with type 1 diabetes [37078/21]
View answerAs 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.
2232. Deputy Michael Healy-Rae asked the Minister for Health the reason full physiotherapy treatments have not been made available for public patients in Kenmare Community Hospital; and if he will make a statement on the matter. [37079/21]
View answerAs 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 ongoing, 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.
2233. Deputy Michael Healy-Rae asked the Minister for Health the status of an appointment for a person (details supplied); and if he will make a statement on the matter. [37080/21]
View answerAs 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.
2234. Deputy Richard Bruton asked the Minister for Health if he has issued a direction to the HSE to ensure that if there are delays due to Covid-19 in registering new born babies on to medical cards that the cost of any treatments would be refunded; and if he will make a statement on the matter. [37081/21]
View answerThe Health Service Executive (HSE) National Medical Card Unit (NMCU) has responsibility for the processing of medical card applications. A key performance indicator within the HSE NMCU is the processing of Medical Card and GP Visit Card applications within 15 working days of receipt of a completed application. The HSE NMCU have confirmed that the processing of applications has not been delayed as a result of the Covid-19 pandemic, despite the unprecedented challenges and capacity constraints experienced by the HSE since March 2020. For example, prior to the onset of the recent cyber-attack on the HSE, 99.63% of all applications received by the NMCU were processed within a 15 working day turnaround.
Regarding reimbursement, eligibility for a medical card or GP visit card is granted on the date when a completed application has been assessed and the applicant is awarded eligibility for a card under the scheme guidelines. Expenditure incurred prior to being granted eligibility is not reimbursable.
However, in the specific circumstance relating to the awarding of a GP visit card for children under 6 years of age, it should be noted that in cases where an applicant does not yet hold a PPSN, it is still possible to apply for an under 6s GP Visit Card through the HSE NMCU online application portal. In such cases eligibility is issued for a 3-month period, after which a PPSN number will be required to complete the application process.
2236. Deputy Róisín Shortall asked the Minister for Health the efficacy of a vaccine (details supplied) in cases in which the second dose is reduced to a four-week interval in respect of the reduced risk of serious illness and hospitalisation and transmission; the rates of efficacy as compared to an eight-week or 12-week interval; and if he will make a statement on the matter. [37083/21]
View answerCovid-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. Each of the authorised vaccines are indicated for active immunisation to prevent Covid-19. The vaccine manufacturers are required to ensure that their products remain safe and effective for the authorised indication of prevention of Covid-19.
The European Commission (EC) has granted conditional marketing authorisations (CMA) to four vaccines against COVID-19 on foot of a positive recommendation from the European Medicines Agency (EMA). Following the recommendation for use of vaccines against COVID-19 by the EMA and authorisation for use by the EC, the National Immunisation Advisory Committee (NIAC) develops guidance for their use in Ireland which is contained in the Immunisation Guidelines for Ireland. These guidelines are continuously updated and include guidance on all new vaccines as they are approved for use in Ireland.
The Guidelines state:
The vaccine is authorised as a two-dose course 4-12 weeks apart.
The threat of new variants in circulation and evidence of suboptimal protection against the Delta variant after one dose of Vaxzevria® means that the shorter 4-week interval is preferable to ensure earlier protection, if practicable.
It is important to emphasise that vaccination is only one part of our response to the prevention of COVID-19 infection. People who are vaccinated need to continue with all the public health measures that have been proven to reduce the risk of infection, i.e., limiting our social contacts, physical distancing, wearing a mask, hand hygiene, cough etiquette and avoiding non-essential travel until a sufficiently large proportion of the population is immune.
2237. Deputy David Cullinane asked the Minister for Health the occupancy rates of both inpatient acute and ICU beds for each hospital group at 01 July 2021; and if he will make a statement on the matter. [37084/21]
View answerAs 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.
2238. Deputy David Cullinane asked the Minister for Health the health vote actual budget outturn and drawdown for each subhead against allocation for same for Covid and non-Covid funding; the forecast and projected outturn by subhead for year-end; the projected year-end Covid spend; and if he will make a statement on the matter. [37085/21]
View answer2240. Deputy David Cullinane asked the Minister for Health the actual budget outturn per quarter for each health vote subhead in each of the years 2017 to 2020 and to date in 2021. [37087/21]
View answerI propose to take Questions Nos. 2238 and 2240 together.
The outturn for each of the years 2017 to 2020 is available in the Revised Estimates for the Public Service at www.gov.ie/en/collection/e20037-revised-estimates/.
The outturn to date in 2021 is provided in the following table.
2239. Deputy David Cullinane asked the Minister for Health the number of staff recruited and onboarded in 2021 against Budget 2021 targets for the primary community sector and acute sector; the projections for year-end; and if he will make a statement on the matter. [37086/21]
View answerThe 2021 National Service Plan recognised the need for an unprecedented expansion of the permanent health workforce through permanent appointments. Funding has been provided for an increase to approximately 135,655 WTE across the health service by December 2021, which is an increase of 15,838 WTE over funded 2020 levels. There is significant workforce recruitment underway.
The latest available census data we have is for April 2021. At this time, the total health service workforce stands at 128,999 WTE. The total health workforce has increased by 2,825 year-to-date, and by 9,182 WTE since the end of December 2019.
The Pay and Numbers Strategy is currently being revised. Due to the cyber attack, this process has been delayed.
As the impact of the cyber attack on recruitment is as of yet, unknown. It is not possible to project the end year workforce figure at this point.
I invite the Deputy to resubmit their question when the HSE's systems have fully resumed, and more specific detail can be provided.
2241. Deputy Bernard J. Durkan asked the Minister for Health the extent to which progress continues in the construction of the National Children’s Hospital in line with expectations; if any unforeseen obstacles to the project have emerged; and if he will make a statement on the matter. [37138/21]
View answerThe New Children’s Hospital (NCH) Project, comprising the main hospital at St James’s campus in Dublin, and two paediatric outpatient and urgent care centres at Connolly and Tallaght hospitals, is a Government priority.
The NCH project has been subject to delays, but the paediatric urgent care centre at Connolly Hospital is operational and the second centre at Tallaght hospital is expected to open towards the end of 2021, following a handover and a period of operational commissioning and equipping.
Despite delays, and Covid-19 restrictions, significant progress is being made at the St James’s campus, where the main new hospital building is taking shape. Good progress has been made more recently, with the building expected to be weathertight by the autumn, and fit out of rooms, theatres and clinical areas is ongoing.
The contractual completion date of October 2022 and the opening of the hospital following a commissioning period in 2023 will now not be met. However, the main contractor has issued a compliant programme schedule for the completion of the contract with over 40,000 itemised and sequenced actions which outlines completion can be achieved by December 2023. If the main contractor meet its own schedule, this would mean the NCH at St James’s could open in 2024, after necessary commissioning period.
The National Paediatric Hospital Development Board (NPHDB) has the statutory responsibility and resources to plan, design, build, furnish and equip the new children’s hospital and continues to engage with the main contractor to do everything they can to ensure that this new substantial completion date and opening can be met.
However, the NCH project cannot be immune to external risks: Brexit, the global pandemic, the resultant impact on global supply chains and especially those to the construction industry. However, the NPHDB and contractors are working to mitigate those risks in so far as is possible.
2244. Deputy Róisín Shortall asked the Minister for Health if Irish persons who have been diagnosed with Covid-19 while living in the UK can have this information recorded on an Irish digital passport; and if he will make a statement on the matter. [37151/21]
View answerThe Digital COVID Certificate Regulation is intended to facilitate people’s fundamental right to move and reside freely and help to support the lifting of restrictions currently in place in a coordinated manner within the EU.
As the Minister for Health, I am supporting the work of my Department in collaborating with relevant Departments under the leadership of the Department of Taoiseach to assist in the on-going implementation of the EU Digital COVID Certificates.
Arrangements for provision of vaccination certificates to persons not vaccinated in Ireland will be considered once the initial roll-out is in place. There is no provision for the issuing of EU Digital COVID Certificates based on recovery to Irish persons who have been diagnosed in another jurisdiction.
2245. Deputy Róisín Shortall asked the Minister for Health if his attention has been drawn to the statement on the HSE website that there is currently no strong evidence to suggest that SARS-CoV-2 is spread through airborne transmission; and if he will ensure this advice is urgently corrected and updated. [37152/21]
View answerAs 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.
2246. Deputy Róisín Shortall asked the Minister for Health if he will ensure clear public health advice is provided about the importance of good ventilation to mitigate the spread of Covid-19; and if he will ensure that this message is included in all communications with the public. [37153/21]
View answerIt is well recognised that ventilation plays an important factor in reducing the risk of transmission indoors, where individuals may be in close contact, potentially for longer periods of time and in poorly ventilated areas. Building ventilation has remained one element of the broader infection prevention and control (IPC) response over the course of the COVID-19 pandemic. The appreciation of the role of ventilation has evolved in the context of developing experience and evidence; guidance, training, and measures implemented reflects this learning. Ventilation, however, is just one aspect of a suite of control measures that work in tandem to mitigate the spread of COVID-19.
The communication of Public Health Advice will continue to convey strong, clear messaging on the importance of vaccination, physical distancing, avoiding crowded and poorly ventilated spaces, face coverings, and maintaining good hand and respiratory hygiene.
I would draw the deputies attention to the already published information and guidance:
The Expert Group on Ventilation reports, agendas and meeting minutes are available on the gov.ie website: www.gov.ie/en/publication/aa43c-expert-group-on-the-role-of-ventilation-in-reducing-transmission-of-covid-19/#reports
Healthcare sector (HSE-AMRIC guidance):
- “Acute Hospital Infection Prevention and Control Precautions for Possible or Confirmed COVID-19 in a Pandemic Setting V.2.3 09.06.2021” www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/guidance/infectionpreventionandcontrolguidance/InfectionPreventionandControlPrecautionsforAcuteSettings.pdf
- “Interim Guidance on Infection Prevention and Control for the Health Service Executive 2021 V1.3. 11.01.2021” www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/guidance/infectionpreventionandcontrolguidance/hseinfectionpreventionandcontrolguidanceandframework/Interim%20HSE%20Guidance%20on%20IPC.pdf
- More generally, the Health Protection Surveillance Centre (HPSC) has published Guidance on Non-Healthcare Building Ventilation during COVID-19. The Guidance provides broad recommendations, based on the literature, for commercial and public buildings: www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/guidance/infectionpreventionandcontrolguidance/buildingsandfacilitiesguidance/
It is the responsibility of individual Government Departments to provide sector-specific COVID-19 advice on ventilation as per their respective remits. For convenience I have also provided details of guidance published by other Departments and their agencies, questions related to any of the published guidance below should be directed to the appropriate Government Department:
- Education Sector
- www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/guidance/educationguidance/Guidance%20on%20non%20HCbuilding%20ventilation%20during%20COVID-19.pdf
- www.gov.ie/en/publication/ad236-guidance-on-ventilation-in-schools/
- Workplaces, Businesses (including hospitality), Retails Settings, and Shopping Centres:
- A revised Work Safely Protocol (previously the Return-to-Work Protocol) was published on 14th May 2021 as a collaborative effort , led by the Department of Enterprise, Trade and Employment, and involving primarily the Health and Safety Authority (HSA), with significant input by public health from the Health Service Executive (HSE). The revised Protocol incorporates the current advice on the Public Health measures needed to reduce the spread of COVID-19 in the community and workplaces including enhanced detail on ventilation:
- www.gov.ie/en/publication/bb7fd-work-safely-protocol/
- www.nsai.ie/images/uploads/general/NSAI-COVID19-Retail-Guidelines-13012021.pdf
- /www.nsai.ie/images/uploads/general/NSAI-COVID19-Shopping-Centre-Guidelines-13012021.pdf
- Fáilte Ireland: Overview Guidelines to Reopening - failtecdn.azureedge.net/failteireland/Overview-Guidelines-to-Re-opening.pdf
- Fáilte Ireland: Guidelines for Reopening Restaurants and Cafes: failtecdn.azureedge.net/failteireland/Guidelines-for-Re-opening-Restaurants-and-Cafes.pdf
- Fáilte Ireland: Guidelines for Reopening Hotels and Guesthouses: failtecdn.azureedge.net/failteireland/Guidelines-for-Re-opening-Hotels-and-Guesthouses.pdf
- There is also additional guidance on Gov.ie and on the HSE website which outlines the importance of ventilation in households, this can be found here:
- www.gov.ie/en/publication/472f64-covid-19-coronavirus-guidance-and-advice/
- www2.hse.ie/conditions/coronavirus/how-coronavirus-is-spread.html
2247. Deputy Róisín Shortall asked the Minister for Health if he will outline the underlying assumptions in the NPHET models in respect of the hospitalisation projections for the delta variant under each of the four scenarios and the reason these are so different to the experience with delta in the UK; and if he will make a statement on the matter. [37154/21]
View answerThe modelling scenarios begin with some basic assumptions on the effective level of close social contact and the increased transmissibility of the delta variant. The level of close social contact is assumed to increase either to the level seen in early summer 2020 (moderate social contact) or late summer 2020 (higher social contact). The transmissibility of the delta variant is uncertain, so the scenarios use conservative estimates (where the delta variant is 1.97 times more transmissible than the variants circulating in 2020, based on estimates from ECDC) or higher estimates (where delta is 2.4 times more transmissible, based on published UK estimates of the relative transmission advantages of the alpha and delta variants.
This gives four scenarios for transmission, levels of infection and case numbers: optimistic (moderate social contact, conservative transmission advantage for delta), central 1 (higher social contact, conservative transmission advantage for delta), central 2 (moderate social contact, higher transmission advantage for delta), and pessimistic (higher social contact, higher transmission advantage for delta).
We know that the widespread administration of vaccines means that there will be fewer infections, and that infections are less likely to lead to severe disease, hospitalisation and mortality. The models assume that the first dose of a vaccine is approximately 60% effective in preventing symptomatic infection with the alpha variant, and the second dose increases effectiveness in preventing symptomatic infection to 80-90%. Furthermore, one dose of vaccine is assumed to offer 70-85% protection against severe disease, hospitalisation and death due to infection with the alpha variant, with a second dose increasing vaccine effectiveness against severe disease to 90-95%.
Vaccines are known to be less effective in preventing symptomatic infection with delta, and this reduction in vaccine efficacy is taken into account in projecting the number of infections and cases in each scenario. However, the available evidence suggests that vaccines are equally effective in preventing severe disease with delta compared to alpha, and this is assumed to be the case in the models.
When all these factors are taken into account, on average per 1000 cases, the models project 15-25 hospitalisations, 2-3 admissions to ICU, and 2-4 deaths. These ratios are comparable to what is being seen in the UK and other jurisdictions.
