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Tuesday, 27 Jul 2021

Written Answers Nos. 2425-2445

Health Services

Questions (2425)

Seán Canney

Question:

2425. Deputy Seán Canney asked the Minister for Health the protocols that are in place to ensure that parents are given accurate information and offered support when babies are found to have foetal abnormalities; and if he will make a statement on the matter. [37781/21]

View answer

Written answers

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.

Abortion Services

Questions (2426)

Seán Canney

Question:

2426. Deputy Seán Canney asked the Minister for Health the help or protocols that are available to doctors if babies survive late-term abortions; and if he will make a statement on the matter. [37782/21]

View answer

Written answers

As the Deputy will be aware, terminations beyond 12 weeks of pregnancy may be carried out in Ireland under sections 9, 10 and 11 of the Health (Regulation of Termination of Pregnancy) Act 2018.

Section 9 requires that two medical practitioners, having examined the pregnant woman, are of the reasonable opinion formed in good faith that there is a risk to the life, or of serious harm to the health, of the pregnant woman; the foetus has not reached viability; and it is appropriate to carry out the termination of pregnancy in order to avert the risk concerned. One of the two medical practitioners must be an obstetrician; and the other must be an appropriate medical practitioner, and both must certify their opinions in order for the termination to be carried out.

Section 10 deals with emergency situations, and provides that a termination of pregnancy may be carried out by a medical practitioner who, having examined the pregnant woman, is of the reasonable opinion formed in good faith that there is an immediate risk to the life or of serious harm to the health of the pregnant woman, and it is immediately necessary to carry out the termination of pregnancy in order to avert that risk.

Section 11 deals with cases where there is a condition present affecting the foetus that is likely to lead to the death of the foetus before or within 28 days of birth. It requires the involvement of two medical practitioners, one of whom must be an obstetrician and the other a medical practitioner of a relevant specialty. Both must examine the pregnant woman and both must certify their reasonable opinion, formed in good faith that the termination of pregnancy can be carried out. The termination of pregnancy must then be carried out by the certifying obstetrician, or in cases where the second certifying doctor is also an obstetrician, either one may carry out the procedure.

Medical practitioners are bound through professional regulatory mechanisms to operate in accordance with best medical practice.

Clinical guidelines for the provision of termination of pregnancy services, within the legal framework set out in the Health (Regulation of Termination of Pregnancy) Act 2018, have been developed by the relevant professional medical bodies.

Abortion Services

Questions (2427)

Seán Canney

Question:

2427. Deputy Seán Canney asked the Minister for Health if his Department advocates the use of dilation and evacuation in late-term abortions; if the electorate was informed in advance of the referendum campaign that such abortions would be illegal; and if he will make a statement on the matter. [37783/21]

View answer

Written answers

As the Deputy will be aware, the Health (Regulation of Termination of Pregnancy) Act 2018 sets out the grounds on which termination of pregnancy may legally be provided in this country. Beyond 12 weeks of pregnancy, the legislation permits termination to be carried out in cases where there is a risk to the life, or of serious harm to the health, of the pregnant woman; in emergency situations where there is an immediate risk to the life, or of serious harm to the health, of the pregnant woman; or where there is a condition present which is likely to lead to the death of the foetus either before or within 28 days of birth.

The Department of Health does not advocate on clinical procedures; it would not be appropriate for the Department to intervene in medical practice or decision-making. Medical practitioners are bound through professional regulatory mechanisms to operate in accordance with best medical practice. In addition, clinical guidelines for the provision of termination of pregnancy services, within the legal framework set out in the Health (Regulation of Termination of Pregnancy) Act 2018, have been developed by the relevant professional medical bodies.

A draft General Scheme of a Bill to Regulate Termination of Pregnancy was published on the Department of Health website in advance of the referendum held on 25 May 2018, so that voters would be aware of the Government’s policy/legislative intentions should the referendum pass. Key elements of the Health (Regulation of Termination of Pregnancy) Act 2018, in particular the grounds on which termination of pregnancy may be carried out, remain the same as those set out in the draft General Scheme published in March 2018.

Covid-19 Pandemic

Questions (2428, 2532)

Róisín Shortall

Question:

2428. Deputy Róisín Shortall asked the Minister for Health the criteria for determining a close contact in the case of a person who travelled on an airplane and then tests positive for Covid-19; the distance other passengers would have to be to the source of transmission on the plane in order to be deemed a close contact; and if he will make a statement on the matter. [37786/21]

View answer

Cian O'Callaghan

Question:

2532. Deputy Cian O'Callaghan asked the Minister for Health if all persons who travelled on the same flight as a person that has Covid-19 are deemed close contacts; the level of proximity used to determine this; and if he will make a statement on the matter. [38002/21]

View answer

Written answers

I propose to take Questions Nos. 2428 and 2532 together.

Close contact guidance is kept under continuing review by the Health Protection Surveillance Centre and is updated and published on its website on a regular basis. The current definition of a close contact, as described in the guidance available at www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/guidance/contacttracingguidance/, includes a close contact as being "Passengers on an aircraft sitting within two seats (in any direction) of the case, travel companions or persons providing care, and crew members serving in the section of the aircraft where the index case was seated." The guidance also outlines that “contact needs to have occurred during the infectious period”. In addition, “if severity of symptoms or movement of the case indicate more extensive exposure, passengers seated in the entire section or all passengers on the aircraft may be considered close contacts”. However, there are different enhanced contact tracing arrangements which apply in relation to investigation of confirmed or suspected cases involving variants of concern, details of which are available at www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/sars-cov-2variantsofconcern/.

The Deputy is advised that the management of close contacts and particularly those relating to variants of concern can change rapidly and the guidance may therefore change relatively frequently and is updated accordingly.

Departmental Bodies

Questions (2429)

Thomas Gould

Question:

2429. Deputy Thomas Gould asked the Minister for Health the format and make-up of the National Oversight Committee with responsibility for the National Drugs Strategy. [37788/21]

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Written answers

The national drug strategy, Reducing Harm, Supporting Recovery, sets out government policy on drug and alcohol use for the period 2017 to 2025. The strategy established the National Oversight Committee to give leadership and direction to support the strategy, and provided that the Minister for State with responsibility for the drugs strategy would chair this committee.

The Committee meets on a quarterly basis and is chaired by the Minister of State with responsibility for the National Drugs Strategy.

The Committee has a cross-sector membership from the statutory, community and voluntary sector, as well as clinical and academic expertise. The strategy provides for membership at Assistant Secretary level. It was a matter for the Minister of State to determine the final membership of the Committee.

The current membership of the National Oversight Committee is set out below

Sector

Body

Statutory

Department of Health

Statutory

Department of The Taoiseach

Statutory

Health Service Executive

Statutory

Health Research Board

Statutory

Department of Justice and Equality

Statutory

An Garda Síochána

Statutory

Irish Prison Service

Statutory

The Probation Service

Statutory

Revenue Commissioners

Statutory

Department of Children and Youth Affairs

Statutory

TUSLA

Statutory

Department of Education and Skills

Statutory

Department of Employment Affairs & Social Protection

Statutory

Department of Housing, Planning, Community and Local Government

Statutory

Department of Rural and Community Development

Statutory

Department of Transport, Tourism and Sport

Statutory

Department of Finance

Community

Community Sector

Community

National Family Support Network

Community

Union for Improved Services Communication and Education

Voluntary

Voluntary Drug Treatment Network

Task Force

Local Drug and Alcohol Task Force Coordinators Network

Task Force

Local Drug and Alcohol Task Force Chairs Network

Task Force

Regional Drug and Alcohol Task Force Chairs Network

Task Force

Regional Drug and Alcohol Task Force Coordinators Network

Appointees of the Minister

Home Help Service

Questions (2430)

David Cullinane

Question:

2430. Deputy David Cullinane asked the Minister for Health the number of different providers which are currently contracted to provide HSE home help; the number of service level agreements and providers for each CHO; and if he will make a statement on the matter. [37790/21]

View answer

Written answers

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.

National Children's Hospital

Questions (2431)

Peadar Tóibín

Question:

2431. Deputy Peadar Tóibín asked the Minister for Health the costs to date of the construction and associated costs of the new national children’s hospital. [37796/21]

View answer

Written answers

The approved budget for the new children's hospital capital (NCH) project is €1.433bn. The National Paediatric Hospital Development Board (NPHDB) has undertaken a detailed assessment of the NCH project to determine the implications of any delay(s), and to determine the most effective pathway to ensure the timely completion of this critical project. Further, ongoing analysis is required by the NPHDB on forecasted costs and potential budget increases arising from delays.

As this project is now subject to a live contract, any considerations on costs outside of the approved budget are commercially sensitive and must remain confidential. Therefore, a definitive update on costs cannot be provided as it would be inappropriate, would prejudice engagement between the parties to the contract, and could very likely negatively impact or jeopardise this critical project.

National Children's Hospital

Questions (2432)

Peadar Tóibín

Question:

2432. Deputy Peadar Tóibín asked the Minister for Health the estimated total projected costs of the construction and associated costs of the new national children’s hospital. [37797/21]

View answer

Written answers

The approved budget for the new children's hospital capital (NCH) project is €1.433bn. The National Paediatric Hospital Development Board (NPHDB) has undertaken a detailed assessment of the NCH project to determine the implications of any delay(s), and to determine the most effective pathway to ensure the timely completion of this critical project. Further, ongoing analysis is required by the NPHDB on forecasted costs and potential budget increases arising from delays.

As this project is now subject to a live contract, any considerations on costs outside of the approved budget are commercially sensitive and must remain confidential. Therefore, a definitive update on costs cannot be provided as it would be inappropriate, would prejudice engagement between the parties to the contract, and could very likely negatively impact or jeopardise this critical project.

Departmental Data

Questions (2433)

Peadar Tóibín

Question:

2433. Deputy Peadar Tóibín asked the Minister for Health the number of legal cases brought against his Department in each of the past five years and to date in 2021; and if he will provide details on the nature of these cases. [37799/21]

View answer

Written answers

The information requested by the Deputy is not immediately available. I will survey the Department and the collated replies will be prepared into a full response to the Deputy as soon as possible.

Covid-19 Pandemic

Questions (2434)

Danny Healy-Rae

Question:

2434. Deputy Danny Healy-Rae asked the Minister for Health the steps he will take for critically ill patients to ensure that their treatment is not interrupted (details supplied). [29609/21]

View answer

Written answers

The National Action Plan on Covid-19 identified the continued provision of cancer care as a priority.

Performance at the end of 2020 is as follows:

- Attendances at Rapid Access Clinics in 2020 was at 88% of 2019 activity;

- Radiation Oncology in 2020 was at 93% of 2019 activity;

- Medical Oncology in 2020 was at 90% of 2019 activity; and

- Surgical Oncology (excluding private hospital activity) in 2020 was at 82% of 2019 activity.

While the ransomware attack in May this year has had an impact on cancer services, every effort is being made to maintain services at present, with a particular focus on urgent and time-sensitive cases.

Funding of €12m was allocated this year for the restoration of cancer services to 95% of 2019 (pre-Covid) levels. In addition, as part of Budget 2021, an extra €20m was allocated for the continued implementation of the National Cancer Strategy.

Care Services

Questions (2435)

Denis Naughten

Question:

2435. Deputy Denis Naughten asked the Minister for Health if he plans to establish a carer's commission to address the issues being experienced by family carers; and if he will make a statement on the matter. [34168/21]

View answer

Written answers

As the Deputy will be aware, my Department is responsible for coordinating the cross-departmental National Carers' Strategy and leading on the health aspects of the strategy. Within this context, there are a number of fora through which my Department regularly communicates and consults with key stakeholders, including groups representing the interests of family carers. Last September, the Minister for Older Persons and Mental Health held a carers round table to listen to the concerns raised by family carers, including their experience during the Covid-19 pandemic. My Department also actively participates in the Annual Carers' Forum organised by the Department of Employment Affairs and Social Protection.

The Programme for Government commits to an update of the National Carers Strategy which is a priority for my Department. My Department is committed to consulting widely with key stakeholders in the context of the planned update.

Eating Disorders

Questions (2436)

Cormac Devlin

Question:

2436. Deputy Cormac Devlin asked the Minister for Health the year-on-year figures for the past four years of those adolescents and adults presenting to the HSE with eating disorders; and the practical measures and supports being put in place to assist those presenting and their families. [28717/21]

View answer

Written answers

Enhancement of specialist services for eating disorders, including improved access and shorter waiting lists, remains a key priority for me, Government as a whole and the HSE.

In response to the growth in cases presenting to mental health services, €5.7 million has been allocated for the Eating Disorders National Clinical Programme since 2016. The Eating Disorders Model of Care was launched in 2018 and was developed in partnership with the College of Psychiatrists of Ireland and Bodywhys, the national support group for people with eating disorders.

€1.77 million has been invested to date in eating disorder specialist posts, with 21.8 WTEs now in place. In addition, I secured the balance of €3.94 million for 2021 and this will enable further investment in specialist posts throughout this year. More specifically, it will allow for the establishment of 3 new specialist eating disorder teams and the completion of the 3 existing specialist teams. Premises are already under development for the expansion of the adult community team at the Mount Carmel site, and is expected to be completed by the end 2021. Recruitment is progressing well for all teams.

The funding allocated to date has seen significant growth and improvement in our services. Despite the significant increase in referrals in 2020, there was a 43% increase in the number of eating disorder assessments completed, compared to 2019, with twice as many people starting treatment.

As of last year, there are 3 specialist eating disorder teams in place. This means that we can treat over 90% of people with eating disorders in the community, avoiding more serious inpatient treatment.

Specialist outpatient treatment has been found to be the most effective and fastest way for most people with eating disorders to recover. Although there is good evidence that inpatient psychiatric care is not required for most people with eating disorders, it is recognised that a small number of people, mainly with restrictive eating disorders, require inpatient care for short periods, for structured refeeding and/or stabilisation.

There are currently 2 eating disorder specialist community teams based in CAMHS, one in CHO4 Cork and Kerry Regional Eating Disorder Service CAREDS (operational since May 2019) and the other based in CHO7 Linn Dara Community Eating Disorder Service LDCEDS (operational since April 2018). Funding has been made available in 2021 to progress the recruitment of an additional CAMHS based eating disorder specialist community team in Community Healthcare West (Galway, Mayo and Roscommon, CHO2).

In circumstances where in-patient care is required, child and adolescent care is provided in all of the 4 Regional CAMHS Units across the country. Linn Dara (8 beds) and Merlin Park (6 beds) have dedicated a number of specialist eating disorder beds, while the remaining 2 CAMHS units accept relevant admissions of children with eating disorders. There is national coordination of child and adolescent admissions, with transfer arrangements in place as required by individual clinical need.

There are plans for an Eating Disorder Unit in the new National Children’s Hospital which will provide 8 additional beds. The HSE also funds individuals in private facilities. Decisions are made based on individual clinical need, as assessed by the local mental health team, and the prioritisation of available funding.

For adults, people who require in-patient care are admitted to local general adult approved centres and attend generic inpatient treatment programmes. CHO6 has 3 dedicated beds for eating disorders based in St. Vincent’s University Hospital. The number of adult beds will increase, in line with the National Clinical Programme, including an additional 3 beds in St. Vincent's, 5 beds in North Dublin, 5 beds in Galway and 5 beds in Cork. Timeframes for new beds will have to be established. These beds will be linked to eating disorder hubs. The funding available for 2021 will allow for the creation of 2 new adult eating disorder hubs in CHO4 and CHO9.

Importantly, adults with eating disorders can also access treatment from local community mental health teams. There are currently 112 adult community mental health teams nationwide. Children and adolescents can similarly access treatment through the 72 CAMHS teams units nationwide.

The HSE provides funding annually to Bodywhys to run a helpline which is delivered by a team of trained volunteers. They also provide a range of services (support groups, online groups, email and family programmes) for adults and young people with eating disorders, and their families. The HSE also supports Bodywhys to run the PiLaR (Peer Led Resilience) Programme, a 4-week online modular based programme for parents, friends and carers of a person with an eating disorder to build resilience and gain support in their role as a carer. Additionally, in March 2019 the HSE has launched the first Self Care App which provides valuable information for those with or people caring for someone with an eating disorder.

People with eating disorders can additionally avail of our general mental health supports. The HSE provide a mental health text messaging support service, which is available 24 hours a day, 7 days each week to connect people with trained volunteers. Online counselling and supports are provided by Turn2Me, MyMind and other organisations. There are phone, text and email supports available through existing providers such as the Samaritans, Aware, Pieta and others. Furthermore, Jigsaw provides a variety of online, phone and text supports specifically to young people aged 12 to 25 years old.

If an individual is concerned about themselves or someone known to them, they should be directed to their GP in the first instance for primary care screening assessment and examination. Their GP may then make recommendations which may include, if clinically indicated, referral to the secondary care mental health services for full eating disorder assessment.

With respect to your question regarding the year-on-year figures for the past four years of those adolescents and adults presenting to the HSE with eating disorders, as it 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.

With the right support and intervention, people can and do recover from eating disorders. The Government and the Department, along with the HSE and its partners, are committed to providing and expanding high-quality treatment and support for all those affected by eating disorders.

Health Services

Questions (2437)

Cormac Devlin

Question:

2437. Deputy Cormac Devlin asked the Minister for Health the numbers of cancers diagnosed in lung and prostate cancer rapid access clinics and symptomatic breast disease clinics from 1 January to 31 December 2020 compared to the same period in 2019, by hospital; the number of persons triaged as urgent and non-urgent that are currently waiting to be seen in lung and prostate cancer rapid access clinics and symptomatic breast disease clinics; and the length of time they have been waiting. [28718/21]

View answer

Written answers

The National Action Plan on Covid-19 identified the continued provision of cancer care as a priority. Cancer services continue to operate in line with guidance issued by the HSE's National Cancer Control Programme (NCCP). However, the number of people coming forward to their GPs, being referred to Cancer Rapid Access Clinics and attending these clinics decreased significantly in mid-March to May 2020 largely due to the fears in regard to Covid-19, and the reaction of people to restrictions in place at that time. These figures improved significantly in the latter half of 2020.

In 2020, diagnoses at Rapid Access Clinics (RACs) for patients with suspected Breast, Lung and Prostate cancer were at 93.7% of the comparable period in 2019. This is broken down across each clinic as follows:

Cancers Diagnosed

Breast

Lung

Prostate

All Clinics

2020

2,957

1,527

1,390

5,874

2019

2,915

1,600

1,754

6,269

2020 as % of 2019

101.4%

95.4%

79.2%

93.7%

For the period January - April 2021 there were 16,960 attendances across all clinics. This compares to 16,825 attendances in the same period in 2019. The adherence to time to treatment KPI's for each of the clinics for January to April 2021 are as follows:

Urgent Symptomatic Breast Disease Clinics

Hospital

KPI

Jan-21

Feb-21

Mar-21

Apr-21

National

95% within 10 days

68.2%

77.9%

70.5%

59.1%

St. James's

95% within 10 days

51.9%

97.5%

60.9%

35.5%

Mater

95% within 10 days

46.7%

27.0%

23.4%

19.2%

SVUH

95% within 10 days

99.0%

99.0%

99.2%

99.6%

Beaumont

95% within 10 days

100.0%

99.1%

99.6%

100.0%

Galway

95% within 10 days

60.1%

49.5%

31.5%

30.6%

Letterkenny

95% within 10 days

98.5%

100.0%

96.4%

100.0%

Cork

95% within 10 days

28.4%

88.6%

91.7%

17.9%

Waterford

95% within 10 days

86.4%

99.1%

96.3%

97.6%

Limerick

95% within 10 days

100.0%

100.0%

100.0%

100.0%

Non-Urgent Symptomatic Breast Disease Clinics

Hospital

KPI

Jan-21

Feb-21

Mar-21

Apr-21

National

95% within 12 weeks

57.8%

52.1%

40.6%

37.6%

St. James's

95% within 12 weeks

33.2%

26.9%

40.4%

53.1%

Mater

95% within 12 weeks

63.6%

75.2%

66.9%

82.9%

SVUH

95% within 12 weeks

54.9%

48.0%

27.7%

11.6%

Beaumont

95% within 12 weeks

89.0%

93.8%

95.0%

97.5%

Galway

95% within 12 weeks

60.0%

11.5%

9.4%

5.4%

Letterkenny

95% within 12 weeks

94.5%

64.3%

56.5%

34.1%

Cork

95% within 12 weeks

97.0%

22.3%

13.1%

10.6%

Waterford

95% within 12 weeks

86.4%

99.1%

63.9%

27.7%

Limerick

95% within 12 weeks

38.5%

100.0%

6.5%

8.3%

Lung Rapid Access Clinics

Hospital

KPI

Jan-21

Feb-21

Mar-21

Apr-21

National

95% with 10 days

87.3%

95.1%

93.1%

94.1%

St. James's

95% with 10 days

100.0%

100.0%

94.6%

98.3%

Mater

95% with 10 days

92.6%

100.0%

100.0%

100.0%

SVUH

95% with 10 days

100.0%

100.0%

100.0%

100.0%

Beaumont

95% with 10 days

100.0%

100.0%

100.0%

100.0%

Galway

95% with 10 days

90.0%

94.6%

98.6%

100.0%

Cork

95% with 10 days

90.0%

77.8%

96.0%

88.5%

Waterford

95% with 10 days

90.9%

90.9%

75.9%

100.0%

Limerick

95% with 10 days

66.2%

90.4%

80.0%

73.1%

Prostate Rapid Access Clinics

Hospital

KPI

Jan-21

Feb-21

Mar-21

Apr-21

National

90% within 20 days

53.5%

54.5%

58.2%

64.0%

St. James's

90% within 20 days

36.8%

70.3%

90.6%

100.0%

Mater

90% within 20 days

83.3%

94.1%

100.0%

100.0%

SVUH

90% within 20 days

93.8%

93.5%

100.0%

100.0%

Beaumont

90% within 20 days

100.0%

100.0%

100.0%

100.0%

Galway

90% within 20 days

8.2%

33.3%

22.0%

10.0%

Cork

90% within 20 days

100.0%

28.6%

30.4%

26.7%

Waterford

90% within 20 days

20.0%

15.9%

32.7%

64.4%

Limerick

90% within 20 days

54.8%

63.6%

51.7%

65.6%

While the recent ransomware attack has had an impact on cancer services, every effort is being made to maintain services at present, with a particular focus on urgent and time-sensitive cases.

While capacity across our cancer services has been reduced due to the increased need for physical distancing and infection control measures, funding of €12m has been allocated in 2021 for the restoration of cancer services in the context of Covid-19. This will support diagnostic services, virtual clinics & triage, organisation of treatment services, minor capital works and psycho-social supports.

In addition, as part of Budget 2021, an extra €20m has been allocated for the continued implementation of the National Cancer Strategy this year. This funding is being used to facilitate developments across prevention, diagnosis, treatment and patient supports.

Vaccination Programme

Questions (2438)

Alan Dillon

Question:

2438. Deputy Alan Dillon asked the Minister for Health if he will outline the strategy for vaccine production to combat emerging Covid-19 variants and future pandemics. [16821/21]

View answer

Written answers

Ireland continues to participate in the EU procurement process operated by the European Commission to secure safe and effective COVID-19 vaccines.

The vaccine procurement strategy has sought to purchase a range of available vaccines to ensure a diversified vaccine portfolio and sufficient quantities to commence and rollout an unprecedented immunisation programme.

Ireland has recently entered into Purchase Agreements with vaccine manufacturers Pfizer/BioNTech and Moderna. Both agreements contain provisions to allow for the adaptation of the current vaccine to combat emerging variants of concern.

Cybersecurity Policy

Questions (2439)

Ruairí Ó Murchú

Question:

2439. Deputy Ruairí Ó Murchú asked the Minister for Health the status of the recovery plan for HSE services and patients impacted by the cybersecurity incident; and if he will make a statement on the matter. [28585/21]

View answer

Written answers

On 23 March 2021 the HSE published the “Safe Return to Health Services ” Plan. This Plan provided an operational framework for the safe return to services in a COVID environment at a local level. It included 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 emphasise that every phase was informed by clinical guidance and putting patient safety first.

Following an analysis of need, capacity and patient safety, and taking into account scenario models, the Plan outlined a phased approach for the proposed restoration of services across Community Services, Acute Operations, Cancer Services and Screening Services.

While much progress has been made on the Plan, health care services have also been impacted by the cyber-attack. The HSE has been working since 14 May last to recover the effects of the cyber attack on its systems. The attack had the impact of removing access to most patient and care systems as well as the central business systems of the HSE. Over the last weeks many of these systems have been recovered and services have recommenced. There was a priority focus on key systems in the hospital and community areas with a view to resuming vital services. Some of the key areas recovered included, radiotherapy, laboratory, imaging, pharmacy, mental health systems, email and patient administration systems.

At present most systems are operational and services are returning to normal activity. There is a challenge in back entering data and indeed loss of records at a time when the HSE was working mostly on paper based processes

As this Parliamentary Question also relates to operational issues, it is a matter for the HSE to reply. 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.

Cybersecurity Policy

Questions (2440, 3343, 3344)

Ruairí Ó Murchú

Question:

2440. Deputy Ruairí Ó Murchú asked the Minister for Health the status of the full extent of the cyber security incident; and if he will make a statement on the matter. [28586/21]

View answer

Gary Gannon

Question:

3343. Deputy Gary Gannon asked the Minister for Health the service framework, governance framework and technical framework in place prior to the HSE ransomware attack as recommended by the HSE Chief Information Officer. [41406/21]

View answer

Gary Gannon

Question:

3344. Deputy Gary Gannon asked the Minister for Health the service framework, governance framework and technical framework now in place since the ransomware attack on the HSE. [41407/21]

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Written answers

I propose to take Questions Nos. 2440, 3343 and 3344 together.

The Health Service Executive (HSE) reported to the Joint Committee on Health on 23 June 2021 with an update on the extent and response to the cyberattack which can be found on the Oireachtas website at the following link:

data.oireachtas.ie/ie/oireachtas/debateRecord/joint_committee_on_health/2021-06-23/debate/mul@/main.pdf

The cyberattack had the impact of removing access to most patient and care systems as well as the central business systems of the HSE. I have been advised that over the last weeks many of these systems have been recovered and services have recommenced. Some of the key areas recovered included, radiotherapy, laboratory, imaging, pharmacy, mental health systems, email and patient administration systems.

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. With the support of the Department of Health, it 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 Department of Health became aware of some irregular activity on its network on the afternoon of Thursday 13 May 2021, and immediately notified the National Cyber Security Centre (NCSC) and implemented further security measures. The attack was contained and prevented from executing across the ICT infrastructure. All ICT systems were immediately shut down as a precautionary measure.

Improved security measures have already been put in place within the Department of Health ICT systems. A complete security review of the ICT infrastructure is currently 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.

The Department of Health and the HSE continue to liaise closely with the National Cyber Security Centre and other strategic stakeholders to ensure that best practice is followed as it relates to all aspects of cyber security.

Disability Services

Questions (2441)

Thomas Pringle

Question:

2441. Deputy Thomas Pringle asked the Minister for Health the ways in which disabled persons are consulted relating to budgetary decisions affecting them; the ways in which his Department respects the nothing about us without us ethos; and if he will make a statement on the matter. [28226/21]

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Written answers

There is continuous engagement by my Department with disability representatives on policy matters. The Department of Health’s Disability Consultative Committee meets generally three to four times a year. The Health Service Executive holds regular meetings with disability representatives through its Disability Consultative Forum, now renamed the National Consultative Committee, whose membership is being broadened to include service providers, family representatives, and the voice of people with disabilities. These meetings are an opportunity to hear from disability representatives on their priorities for services.

These fora are an integral part of a wider consultative process with disability stakeholders which oversees and monitors the implementation of the National Disability Inclusion Strategy, including the Department of Health’s commitments under that strategy. Under my chairmanship, the National Disability Inclusion Strategy Steering Committee, comprising disability representatives from the Disability Stakeholder group and departmental officials meets around three times a year. The National Disability Inclusion Strategy in turn was developed following three separate phases of consultation with disability stakeholders.

Under the auspices of the Department of Social Protection, almost 2,500 people, responded to a recent survey which explored among other factors, the health-funded services they were receiving, and the adequacy of those services to meet their needs. The survey participants comprised a random sample of those on disability payments, and other participants contacted via disability organisations. The Department of Health will be closely studying the findings to inform budgetary deliberations.

The Government welcomes the widespread engagement of disability representative organisations in ongoing discussion of policy and resource matters through channels including those listed above, which ensure the voice of people with disabilities is heard in matters affecting them.

While the input of people with disabilities is an important strand of all policy preparations, under the Constitution, it is Dáil Éireann which decides on budgetary allocations recommended by the Government, through adopting the Estimates.

Hospital Waiting Lists

Questions (2442)

Jennifer Whitmore

Question:

2442. Deputy Jennifer Whitmore asked the Minister for Health the efforts he has taken to date to address the long waiting list for children with scoliosis seeking surgery; the impact Covid-19 has had on waiting lists; and if he will make a statement on the matter. [28190/21]

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Written answers

I sincerely regret that children can experience a long waiting time for hospital appointments and treatment, and I remain conscious of the burden that this places on them and their families.

It is recognised that progress that was being made in waiting times for hospital appointments, procedures, and services, has been impacted since March 2020 as a direct result of the COVID-19 pandemic, and more recently by the cyber-attack on the HSE on 14 May. This attack has impacted all acute hospitals and their services.

Children’s Health Ireland (CHI) has advised my Department that their systems have been significantly impacted by the attack and they are currently running a press and communication campaign to advise patients of the service disruption. Up to date information on current services is also provided on the Children’s Health Ireland website.

Children’s Health Ireland (CHI) continue to work with the HSE and National Treatment Purchase Fund to identify and support solutions to improve access to care, particularly in the context of the Covid-19 pandemic and the recent cyber-attack.

Despite the challenges resulting from the Covid-19 pandemic last year, by 31 December 2020 Children’s Health Ireland had carried out 322 scoliosis procedures, 163 of which were spinal fusions, and 159 other spinal procedures. Overall, scoliosis activity figures for 2020 were 16% lower than in the previous year, despite significant social distancing measures and Infection Prevention and Control requirements.

As a result of the cyber-attack, the most recent data available on scoliosis is from the 7th May 2021, when Children’s Health Ireland had carried out 73 Spinal Fusions, and 74 other spinal procedures, an overall increase of 44 procedures on the same period last year.

Children’s Health Ireland has advised that as of 7 May 2021, there were 118 patients on the spinal fusion waiting list (excluding suspensions), an increase of 10 patients compared to the end of May 2020. There were 72 patients on the waiting list for other spinal procedures (excluding suspensions), which is a decrease of 5 patients compared to the end of May 2020. These figures should be interpreted in the context of the curtailment of services in 2020 in line with social distancing measures and Infection Prevention and Control requirements

An additional €240 million has been provided in Budget 2021 for access to care, €210m of which has been allocated to the HSE and a further €30m to the NTPF. This is to be used to fund additional capacity to address the shortfall arising as a result of infection control measures taken in the context of COVID-19, as well as addressing backlogs in waiting lists.

My Department, the HSE and the NTPF are currently in the process of finalising a Multiannual Waiting List plan to address waiting lists and bring them in line with Sláintecare targets over the coming years.

Vaccination Programme

Questions (2443)

Jennifer Whitmore

Question:

2443. Deputy Jennifer Whitmore asked the Minister for Health the efforts he has taken to provide an alternative vaccination centre in Arklow for persons in south County Wicklow after the centre was discontinued; and if he will make a statement on the matter. [28191/21]

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Written answers

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 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.

Regulatory Bodies

Questions (2444)

Denis Naughten

Question:

2444. Deputy Denis Naughten asked the Minister for Health the current processing times for applications for registration with CORU by physiotherapists; if any delays are being experienced; and if he will make a statement on the matter. [37844/21]

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Written answers

CORU has provided a breakdown of the average processing times for applications for registration from physiotherapists received from 2016 to date.

Year

Average Days Processing Period from Application Commencement to Registration: Physiotherapy*

2016

461

2017

130

2018

129

2019

70

2020

75

2021

60

As is apparent from this data, the period required to process such applications has improved in 2021. CORU has also informed the Department that the registration time from submission of completed application form is typically shorter than that presented in the data because the current system cannot ascertain when a completed application was submitted, only when the process started online. Significant outliers in which an applicant has not provided information for a significant period of time negatively skew the dataset.

This data reflects standard applications and does not include a number of outstanding grandparenting applications as the grandparenting period is now closed. CORU is currently prioritising these complex applications, the majority of which are incomplete and need to provide further documentation before they can be registered.

I met with the Chairperson and CEO of CORU earlier this year and raised the issue of timeframes for recognition of qualifications and registration. Following our discussion, a variety of measures have been initiated by CORU aimed at further reducing timeframes.

Covid-19 Pandemic

Questions (2445)

Paul Murphy

Question:

2445. Deputy Paul Murphy asked the Minister for Health the number of children with special needs living in south-western areas of Dublin; the number of therapists working in the area to provide essential services for these children; his plans to ensure that these services which are crucial for the families of these children will resume to pre-Covid-19 levels; and if he will make a statement on the matter. [37861/21]

View answer

Written answers

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.

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