Written Answers Nos. 2386-2404
2386. Deputy Réada Cronin asked the Minister for Health the social and certification status and or exemptions of those persons who cannot for medical reasons be vaccinated against Covid-19, for example, in the case of previous anaphylaxis to an ingredient present in all the Covid-19 vaccines offered; and if he will make a statement on the matter. [37659/21]
View answerThe EU Digital COVID Certificate Regulation, which became directly applicable to EU member states on 1 July 2021, is designed to facilitate safe free movement of citizens in the EU during the COVID-19 pandemic. Certificates issued under this Regulation hold digital or paper proof that a person has either been vaccinated against COVID-19, received a negative test result, or recovered from COVID-19 in the last 6 months. It is valid in all EU Member States, including Ireland, EEA states and third countries recognised under an EU implementing act.
It should be noted that while the Regulation aims to facilitate free movement the EU Digital COVID Certificate is not a travel document and the possession of an EU Digital COVID Certificate will not be a precondition to exercise free movement rights. Travellers who do not have a Digital COVID Certificate can provide other verifiable forms of proof of vaccination, recovery, or a valid negative test under the current travel measures.
2387. Deputy Réada Cronin asked the Minister for Health the systems in place to provide specific clinical advice, support and administrative assistance to persons who wish to be vaccinated against Covid-19 but have a history of anaphylaxis to an ingredient present in all the vaccines offered; and if he will make a statement on the matter. [37660/21]
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.
2389. Deputy Rose Conway-Walsh asked the Minister for Health if suppliers such as photographers, videographers and so on are included in the total number of persons allowed to attend a wedding as part of the Covid-19 restrictions in place since 5 July 2021; and if he will make a statement on the matter. [37662/21]
View answerAs the Deputy will be aware, on 29 June, Government announced the next phase of reopening the economy and society in line with Recovery and Resilience: The Path Ahead.
While significant progress is being made in relation to the roll-out of our vaccination programme, the rapidly increasing prevalence of the more transmissible Delta variant, and the significant risk this poses, in particular to those who are not yet fully vaccinated, meant that a number of higher risk indoor activities did not recommence as planned on 5 July, pending the implementation of a system to verify vaccination or immunity status.
Disease incidence has increased rapidly in recent weeks, especially among those who are not yet fully protected through vaccination and the outlook for the coming weeks is very uncertain.
Suppliers such as photographers and videographers are permitted at weddings and are not included in the guest capacity limit of 50. Further detail of guidelines in place for weddings is available online: failtecdn.azureedge.net/failteireland/Guidelines-for-Re-opening-Hotels-and-Guesthouses.pdf
Significant and sustained progress has been made on suppressing the virus over recent months due to the huge effort of people across the country. By working together, we have saved lives and limited the impact of the disease on society in Ireland. To protect the gains of recent months we must continue to practice basic preventative behaviours and to follow public health guidelines.
2390. Deputy Réada Cronin asked the Minister for Health if a category system can be put in place similar to that which exists in other jurisdictions in which persons who wish to be vaccinated but who have a history of anaphylaxis or other adverse drug reactions are immediately and automatically referred to an immunologist who can manage their case (details supplied); and if he will make a statement on the matter. [37689/21]
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.
2391. Deputy Réada Cronin asked the Minister for Health the reason for the lacuna in the HSE vaccine hotline in relation to anaphylaxis in which no proper information can be given to those anxiously awaiting a vaccination and in relation to the reason a clinic regarding same was cancelled in St. James’s Hospital, Dublin in June 2021 with no firm substitute date given; and if he will make a statement on the matter. [37690/21]
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.
2392. Deputy Neale Richmond asked the Minister for Health the steps that have been taken towards permitting the use of medicinal marijuana; and if he will make a statement on the matter. [37696/21]
View answerThere are two separate pathways for accessing cannabis for medical use in Ireland.
Medical Cannabis Access Programme (MCAP)
The provision of the Medical Cannabis Access Programme (MCAP) as a result of recommendations by the Health Products Regulatory Authority in their “Cannabis for Medical User – A Scientific Review”.
The review stated that if the policy decision is to make cannabis available for medical purposes, the HPRA advised that it should recognise patient need, but be evidence based. It was advised, that treatment with cannabis be only permitted under a controlled access programme for the treatment of patients with the following medical conditions which have failed to respond to standard treatments;
- spasticity associated with multiple sclerosis;
- intractable nausea and vomiting associated with chemotherapy;
- severe, refractory (treatment-resistant) epilepsy.
Subsequently the Minister for Health established an Expert Reference Group to advise on the development of a Medical Cannabis Access Programme. This Group developed detailed Clinical Guidelines for the MCAP to be followed by clinicians, which contained inter alia guidance on ingredient combinations that are recommended for each of the three indications included in the MCAP
The Medicinal Cannabis Access programme (MCAP) is a 5-year pilot programme. The purpose of the programme is to facilitate access to acceptable cannabis-based products for medical use that are of a standardised quality and which meet the requirements outlined in the Misuse of Drugs (Prescription and Control of Supply of Cannabis for Medical Use) Regulations 2019 (as amended).
There are currently 4 products assessed by the HPRA for inclusion in Schedule 1 of the Regulations, more products are currently being assessed by the HPRA.
Reimbursement of the products, prescribed by approved medical consultants and supplied through community pharmacies for a specified therapeutic indication in line with Schedule 2 of the Misuse of Drugs (Prescription and Control of Supply of Cannabis for Medical Use) Regulations 2019 (as amended) will be on an individual named patient basis aligned to the patient’s eligibility under the community drug schemes (Medical Card, Long Term Illness Scheme and Drugs Payment Scheme). It cannot be assumed that reimbursement approval will be forthcoming on submission of applications. A reimbursement decision will be communicated with the prescribing consultant in writing.
On the 19th July, the Minister for Health announced that the MCAP was now open for medical consultants to make an application for themselves and their patients to be registered for the programme.
Registration by consultants and their patients on the Cannabis for Medical Use Register, to be operated by the HSE, is required for the prescribing of cannabis-based products under the MCAP.
Ministerial Licence under Section 14 of the Misuse of Drugs Acts 1977-2016
Pending full operation of the MCAP and for medical indications not included in the MCAP, doctors may continue to utilise the Ministerial licensing route to prescribe medical cannabis for their patients, should they wish to do so.
In line with the Chief Medical Officer's advice, the granting of a licence for cannabis for medical purposes must be premised on an appropriate application being submitted to the Department of Health, which is endorsed by a consultant who is responsible for the management of the patient and who is prepared to monitor the effects of the treatment over time.
Since the first licence issued in December 2016, 178 licences have been approved for the treatment of 64 individual patients.
It is important to note that the medical decision to prescribe or not prescribe any treatment, including cannabis treatment, for an individual patient is strictly a decision for the treating clinician, in consultation with their patient. The Minister for Health has no role in this clinical decision-making process.
2393. Deputy Alan Kelly asked the Minister for Health if he will report on his recent engagements with the President of the European Commission and pharmaceutical executives on Covid-19 vaccine supplies. [20484/21]
View answerIreland continues to participate in an EU Procurement process with a view to accessing a portfolio of candidate vaccines against COVID-19 which are being negotiated with vaccine manufacturers by the Commission acting on behalf of Member States. Officials from the Department of Health are represented on the EU Steering Board which discusses and reviews all aspects of vaccine procurement.
Ireland supports efforts made by the Commission to safeguard the production and delivery of doses of vaccine in the quantities agreed with vaccine suppliers. There is ongoing engagement with vaccine manufacturers under the auspices of the Steering Board.
2394. Deputy Bernard J. Durkan asked the Minister for Health the proposals to upgrade the IT system in his Department and the HSE and or subsidiary bodies with a view to maximising the protection against hackers; and if he will make a statement on the matter. [28646/21]
View answerImproved security measures have already been put in place within my Department’s IT systems. A complete security review of the infrastructure is being finalised and specialised software has been installed to mitigate against malicious software, and to provide early warning notifications of same. The system is fully monitored, providing for a rapid response to any notified incidents.
My Department continues to liaise closely with the National Cyber Security Centre (NCSC), the Office of the Government Chief Information Officer, our security partner and with colleagues across the Public Service to ensure that best practice is followed as it relates to all aspects of cybersecurity.
In the wake of the recent ransomware attack, the HSE has deployed additional security toolsets and capabilities and applied recommendations from external consultants engaged following the ransomware attack. The HSE continues to engage with the NCSC and, with the support of my Department, will continue to invest strategically in technical infrastructure, cyber defences, and the resources necessary to protect the systems and data that are vital to the safe operation of the health system.
The HSE has deployed additional expertise, resources, and technology to provide enhanced monitoring of systems and networks. This is considered an interim measure as they procure a permanent Security Operations Centre to provide security and threat incidence monitoring and response including:
- Monitoring and alerting on portals and software.
- Monitoring and incident management of all devices on the network to ensure that all devices are compliant with rules/policies.
- Threat incident response including triage, close and/or escalation.
Health systems cyber security and disaster recovery protocols will be informed by learnings from the recent criminal ransomware cyberattack. In keeping with procedures on any critical incident, post incident review findings and recommendations will inform the process of continuous improvement. When further planning health ICT systems modernisation and activities, both the Department of Health and the Health Service Executive will be informed by recommendations made by the National Cyber Security Centre and post-incident reporting.
2395. Deputy Joe Carey asked the Minister for Health the status of the accreditation of a vaccine (details supplied) and its path to approval by the European Agencies for Drug Administration for accredited vaccines; and if he will make a statement on the matter. [28313/21]
View answerIreland is participating in an EU Procurement process with a view to accessing a portfolio of candidate vaccines against COVID-19 which are being negotiated with vaccine manufacturers by the Commission acting on behalf of Member States. Emergency Support Instrument (ESI) funding has been leveraged by the Commission to facilitate its negotiations with vaccine manufacturers, including with regard to production costs and securing a reduced per dose cost for Member States.
This process has provided Ireland with access to vaccines (at a reduced cost) that it would find it difficult to access otherwise within a year after the declaration of a Public Health Emergency of International Concern by the WHO. Four of the vaccines in the EU portfolio have already been awarded Conditional Marketing Authorisation (CMA) by the Commission.
Ireland supports efforts made by the Commission to safeguard the production and delivery of doses of vaccine in the quantities agreed with vaccine suppliers and to ensure that up-front funding provided through ESI has been properly used.
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).
The delivery of vaccines under APAs that the Commission has negotiated on behalf of Member States are predicated upon a CMA being obtained from the Commission (on the basis of a positive recommendation being awarded by the EMA).
The awarding of a CMA provides a high level of assurance that a vaccine has undergone rigorous testing and has met the requirements of the independent regulatory process as regards demonstrating its quality, safety and efficacy.
The Sinopharm vaccine has not been awarded a CMA to date.
2396. Deputy Violet-Anne Wynne asked the Minister for Health if there will be a centralised top-down approach to lifting maternity restrictions (details supplied); if not, if hospital groups will be administering an ad hoc, location specific response; and when the Government will adhere to the recommendation by the World Health Organisation that a birthing person has a right to have a partner with them for all of their labour not only at the final hour even during the Covid-19 period. [24207/21]
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.
2397. Deputy Ruairí Ó Murchú asked the Minister for Health if consideration will be given to paying allowances upfront alongside the current review on allowances for student nurses and midwives; and if he will make a statement on the matter. [43337/20]
View answerAs the Deputy will be aware, at the end of 2020 a short-term review of student nurse and midwife allowances in the context of COVID-19 was undertaken at my request by Professor Tom Collins. This review was conducted to examine any additional challenges that the Pandemic may have created for student nurses and midwives on supernumerary clinical placement and final-year internship placement. I accepted all of the recommendations which Prof. Collins made. This includes the payment of a Pandemic Placement Grant (PPG) of €100 per week for each week of supernumerary clinical placement which is backdated to the start of the current academic year, September 2020.
The processing of the payment of these grants is well underway. However, the recent HSE IT disruption did cause some delay to the planned completion by early June. The HSE are working with local clinical sites to ensure that outstanding payments are completed as soon as possible.
I also directed that a second longer-term independent review of student nurse and midwife clinical placement allowances take place. This review will include an examination of the existing clinical placement allowances payable to student nurses and midwives on placement. The terms of reference of the review were agreed in April 2021 with the representative bodies. The review was conducted by Mr Sean McHugh and while the HSE cyberattack delayed its progress, I expect to receive a copy of the review shortly and I look forward to reviewing the contents.
2398. Deputy Ruairí Ó Murchú asked the Minister for Health when he expects the citizens' assembly on drugs to convene; and if consideration has been given to convening this assembly in an online format. [17204/21]
View answerThe Programme for Government includes a commitment to convene a citizen’s assembly to consider matters relating to drug use. The timing of this, and other assemblies, over the lifetime of the Government has yet to be determined. One element critical to the success of assemblies has been the opportunity to meet in person. The restrictions experienced with Covid-19 have presented considerable difficulties in this regard, as meetings moved to being held online. The experiences and learning in this new way of working will inform how future citizen’s assemblies are conducted.
In 2019, the Government agreed to adopt a health-led approach to people who use drugs, following the publication of the report of the working group on alternative approaches to the possession of drugs for personal use, which was informed by 20,000 public responses. The approach will offer compassion, not punishment, to people who use drugs. The Programme for Government endorses this approach as an important step in developing a public health-led approach to drug use.
An implementation group chaired by the Department of Health is finalising plans for the commencement of the Health Diversion Programme in 2021. The aim of the programme is to connect people who use drugs with health services and provide a pathway to recovery, thereby avoiding a criminal conviction. Under the programme, An Garda Síochána will divert a person found in possession of drugs for personal use to the HSE for a health screening and brief intervention
As outlined in the Programme for Government, the programme will be reviewed after the first full year of implementation to ensure that it is meeting all of it aims and to make any necessary changes.
The strategic priority in the EU Drugs Strategy to provide alternatives to coercive sanctions for people who use drugs. Ireland is committed to mainstream the implementation of effective measures that have a rehabilitative element and avoid a criminal sanction. To this end, Ireland will share comprehensive and in-depth data and exchange of best practices on alternatives to coercive sanctions with EU Member States.
I believe that a citizen's assembly could usefully consider the learnings from this programme and similar health-led initiatives in Ireland and internationally. It could also inform the development of new national drugs strategy, to replace the existing strategy when completed in 2025.
2399. Deputy Bernard J. Durkan asked the Minister for Health the extent to which he is in the process of coordinating the Covid-19 vaccination programme with a view to ensuring the most expeditious and strategic delivery of the most appropriate vaccines at the earliest possible time; and if he will make a statement on the matter. [7375/21]
View answer2547. Deputy Bernard J. Durkan asked the Minister for Health the extent to which additional efforts are being made to ensure the availability of the Covid-19 vaccination to the remaining cohort of persons not vaccinated to date; if he will ensure the rapid attention to such cases in order to facilitate the safe early reopening of the economy; and if he will make a statement on the matter. [38105/21]
View answerI propose to take Questions Nos. 2399 and 2547 together.
The Government established the High-Level Task Force (HLTF) on Covid-19 Vaccination on 10 November 2020. The HLTF acts to support my Department and the HSE to deliver a Covid-19 immunisation programme, that meets best practice and provides good governance, as a critical public health intervention in the prevention and control of Covid-19.
In collaboration with my Department and the HSE, the HLTF developed the National Covid-19 Vaccination Strategy, and this was approved by Government on 15 December 2020. The Strategy’s objective has been to ensure the effective and efficient delivery of vaccines to the population.
The Covid-19 Vaccination Allocation Strategy was developed in conjunction with the National Covid-19 Vaccine Strategy. The Allocation Strategy was developed by the National Immunisation Advisory Committee’s (NIAC) and outlined a provisional list of groups for vaccination and was approved by Government on 8 December 2020. The Allocation Strategy has been kept under review in the intervening period and amended as new evidence emerged.
More than 5.3 million vaccine doses have now been administered since the programme began in December 2020. Over 3 million have received a vaccine dose while more than 2.3 million have received two doses. It is currently anticipated that all eligible persons over 16 years who wish to avail of a vaccine will be vaccinated by end-September.
2400. Deputy Bernard J. Durkan asked the Minister for Health the extent to which the health services continue to deal with non-Covid-19 related health issues including hospital admissions, home care, outpatient appointments and admissions for necessary surgery; and if he will make a statement on the matter. [7376/21]
View answerWe are all acutely aware of the impact that COVID 19 has on society, our citizens and on individual service areas.
In the Health Sector, the COVID 19 pandemic has led to unprecedented interruption to normal healthcare activity in both acute and community settings.
To ensure that services were restored in a clinically prioritised manner, the HSE, in March 2021 published a Plan for restoring health and social care services in a COVID 19 environment entitled – ‘Safe Return to Health Services’ .
This Plan provides an operational framework for the safe return to services at a local level. It includes an overview of the services to be resumed, the target for their safe return and some detail on the conditions and challenges that have to be met. It is important to note that every phase outlined in the Plan has been informed by clinical guidance and putting patient safety first.
Prior to that, The National Service Plan 2021 sets out the type and volume of services that the HSE will provide for that year in respect of the funding allocated.
In submitting NSP 2021 for my approval, the HSE committed to keep the Plan under review to assess the impact of COVID 19 on the key transformation programmes and on the original targets and activity levels proposed for this year.
Progress had been made by the HSE with the review, however due to the recent Cyber-attack, the HSE has been requested to extend the review to include both the impact of COVID 19 and the Cyber-attack on the original NSP targets and to produce revised end of year positions which will ensure an effective performance management process for the remainder of 2021. It is expected that this will be completed in mid-July.
As this Parliamentary Question also relates to operational issues, it would be a matter for the HSE to comment on and provide an update to the Deputy, 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.
2401. Deputy Bernard J. Durkan asked the Minister for Health the progress in the implementation of the proposals contained in the Sláintecare report; the way that this will manifest itself in the months ahead; and if he will make a statement on the matter. [28647/21]
View answerThe vision of Sláintecare is to achieve a universal single-tier health and social care system, where everyone has equitable access to services based on need, and not ability to pay and to deliver safe, quality health and social care services that meet the needs of our growing population, and attracts and retains the very best healthcare clinicians, managers, and staff.
Considerable progress has been made in moving from vision to reality. The commitment to Sláintecare was reconfirmed in the Programme for Government and Budget 2021 invested in staffing and infrastructure to enhance the permanent capacity of our health services and expand the scale and range of services to be provided in the community. Major foundational decisions were made by Government, including the establishment of the HSE Board, and the approval of the geographies for six new regional health areas. There has been progress against all of the eight Sláintecare Principles from the Oireachtas Sláintecare Report, including the patient being paramount; timely, needs-based care; prevention and public health; and engagement with citizens and staff. This was done against the backdrop of COVID-19 which has challenged our healthcare systems in a manner never previously seen.
The Government has now approved a new three-year Sláintecare Implementation Strategy & Action Plan 2021-2023. The new plan will build on the commitment and desire for innovation, demonstrated during the pandemic, and build on the unprecedented levels of investment in our health service. The Strategy will focus on two new reform programmes. Programme One: Improving Safe, Timely Access to Care and Promoting Health & Wellbeing will focus on integration, safety, prevention, shift of care to the right location, productivity, extra capacity and achieving Sláintecare waiting time targets. Programme Two: Addressing Health Inequalities will bring us on a journey towards universal healthcare. Eleven associated Projects have been developed and are aligned with key national strategies, policies and initiatives.
2402. Deputy Peadar Tóibín asked the Minister for Health the details of the structures of cross-Border co-operation in the fight against Covid-19. [22907/21]
View answerThere has been, and continues to be, significant engagement and cooperation between the Ministers for Health, the Chief Medical Officers, and the Departments of Health in Ireland and Northern Ireland throughout this pandemic.
Both administrations are seeking to adopt similar approaches, where it is appropriate to do so and on the advice of respective Chief Medical Officers. This approach is underpinned a Memorandum of Understanding agreed by the Chief Medical Officers of the Department of Health and the Department of Health in Northern Ireland in April 2020 to strengthen North South co-operation on the public health response to the COVID-19 pandemic. In November 2020, this overarching agreement was supplemented with a further Memorandum of Understanding in relation to a framework for mutual support for the provision of critical care.
Meetings of the North South Ministerial Council are also an important pillar in our regular engagements with Northern Ireland counterparts on COVID-19.
I am committed to continue this close and productive cooperation with Northern Ireland to foster commonality in approaches, where possible.
2403. Deputy James O'Connor asked the Minister for Health if he will report on the use of rapid antigen testing to enable a return to international travel; and if he will make a statement on the matter. [28641/21]
View answerReverse transcription polymerase chain reaction (RT-PCR) tests remain the gold standard in terms of COVID-19 testing, particularly in relation to the screening of travellers. Ireland does not accept antigen tests for incoming travellers.
COVID-19 tests for the purposes of travel, both to and from the State, can be sourced via private testing providers, in order to preserve the testing capacity of the HSE for priority groups and public health screening. Antigen tests can be sourced via private providers and Digital COVID Certificates based on antigen tests can be issued for the purpose of travelling to an EU country where antigen tests are accepted.
These travel measures are kept under continuous review based on public health advice and the international epidemiological situation.
2404. Deputy Catherine Connolly asked the Minister for Health if an application for planning permission has been made to-date in respect of the planned outpatient block in the Merlin Park campus of Galway University Hospital; and if he will make a statement on the matter. [37744/21]
View answerThe planning application for the Outpatient Block at Merlin Park Development is currently being finalised and is due to be submitted to the local Planning Authority by the middle of August. The proposed project is a Ground & First floor Outpatients Department at Merlin Park University Hospital and will provide additional capacity for outpatient services.
