Written Answers Nos. 2584-2602
2584. Deputy Patrick Costello asked the Minister for Health when he expects NIAC and HSE approval for Covid-19 vaccination of children aged 12 to 15 to be approved; and if he will make a statement on the matter. [38282/21]
View answer2604. Deputy Thomas Gould asked the Minister for Health if consideration will be given to vaccinating high risk under 18s given EU vaccine clearance for the 12 years plus age group. [38335/21]
View answer2628. Deputy Marian Harkin asked the Minister for Health if there are plans to roll out vaccination to the 12 to 15-year old age cohort following the recent approval by the EMA of a vaccine (details supplied) for use in this cohort; and if he will make a statement on the matter. [38441/21]
View answer2629. Deputy Marian Harkin asked the Minister for Health if there are plans to roll out vaccination to the 12 to 15-year old age cohort following the recent approval by the EMA of a vaccine (details supplied) for use for those in this cohort with underlying conditions; and if he will make a statement on the matter. [38442/21]
View answer2687. Deputy Pádraig O'Sullivan asked the Minister for Health if consideration will be given to opening up the Covid-19 vaccination programme to those under the age of 16 years with underlying health conditions; if he will provide a timeline for same; and if he will make a statement on the matter. [38786/21]
View answer2717. Deputy Joe Flaherty asked the Minister for Health when Covid-19 vaccinations will be approved by NIAC for 12 to 15 year-olds; and when they will receive them (details supplied). [38879/21]
View answerI propose to take Questions Nos. 2584, 2604, 2628, 2629, 2687 and 2717 together.
Ireland welcomes the EMA age extension recommendation for the COVID-19 vaccine Comirnaty to include use in children aged 12 to 15. The National Immunisation Advisory Committee are reviewing the matter and will make a recommendation as appropriate. Currently, Ireland's COVID-19 Vaccination Programme is administering vaccines to those aged 16+.
2585. Deputy James Lawless asked the Minister for Health if he will advise on the case of a person (details supplied); and if he will make a statement on the matter. [38283/21]
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.
2586. Deputy Mattie McGrath asked the Minister for Health if it is a requirement for all pharmacists administering a vaccine (details supplied) to follow the standard operating procedures in relation to confirming consent which requires pharmacists to ensure that all vaccine recipients are made fully aware of benefits and risks of vaccine and side effects; if all pharmacists are following the procedure; if pharmacists have received necessary training; if they are in receipt of all relevant data and have been made fully aware of the full range of side effects and benefits of the vaccine as necessary to follow the procedure and ensure informed consent; the actions that can be taken in cases in which a pharmacist fails to follow the procedure in relation to confirming informed consent; the training pharmacists have received; and if he will make a statement on the matter. [38284/21]
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.
2587. Deputy Neale Richmond asked the Minister for Health if those who have received one dose of an EMA approved Covid-19 vaccine who have also recovered from Covid-19 in the previous six months are considered fully vaccinated given the HSE Covid Bulletins 22 and 23 pages 2 and 3 respectively imply that the HSE is not operating this advice and using a two dose system for this group; and if he will make a statement on the matter. [38293/21]
View answerIreland’s COVID-19 vaccination programme strategy is to distribute all available vaccines as quickly as is operationally possible, prioritising those who are most vulnerable to COVID-19. The programme is based on the principles of safety, effectiveness and fairness, with the objective of reducing severe illness, hospitalisations and deaths from COVID-19 infection.
The immunisation programme in Ireland is based on the advice of the National Immunisation Advisory Committee (NIAC). The Committee's recommendations are based on the prevalence of the relevant disease in Ireland and international best practices in relation to immunisation. It makes recommendations on vaccination policy to my Department. The NIAC review all data relating to COVID-19 vaccines on a rolling basis.
Following the recommendation for use of vaccines against COVID-19 by the European Medicines Agency (EMA) and authorisation for use by the European Commission, the 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.
You can read the guidelines at:
www.hse.ie/eng/health/immunisation/hcpinfo/guidelines/covid19.pdf.
The guidelines advise that those diagnosed with COVID-19 within the previous nine months, aged under 50 years and not immunocompromised are considered fully vaccinated after receiving a single dose. It is advised that those aged under 50 years and immunocompromised and those aged older than 50 should receive a full vaccine regimen.
The HSE will continue to offer all people a second dose, regardless of a positive COVID-19 test. The option will remain for individuals to choose not to take their second dose if they so wish.
2588. Deputy Peadar Tóibín asked the Minister for Health the number of hospital beds across the health service; the number of ICU and critical care beds; and the number of mental health beds across the health service. [38294/21]
View answer2590. Deputy Peadar Tóibín asked the Minister for Health the existing capacity of the healthcare service. [38296/21]
View answerI propose to take Questions Nos. 2588 and 2590 together.
Based on provisional data provided by the HSE in April, there was an average of 11,171 inpatient beds and 2,262 day beds/places open in acute hospitals during 2021 from January to the end of March. The Deputy can find further details in this regard in the Department's Open Beds Report for March 2021, which was published online earlier this month: www.gov.ie/en/publication/c17a6-department-of-health-open-beds-report-for-march-2021/.
The Government has funded significant initiatives across the health service to expand capacity, allocating €600m to the HSE Winter Plan 2020/21. An additional 834 acute beds over the number of beds on 1 January 2020 have been delivered, with 229 more expected by the end of this year. In addition, 73 sub-acute beds have been added with 40 more planned by the end of 2021.
At the start of last year, permanent adult critical care capacity in Ireland stood at 255 beds, according to the National Office of Clinical Audit. Funding for a further 40 adult critical care beds was provided as part of the response to Covid-19 in March 2020. A Strategic Plan for Critical Care was noted by Government in December 2020. This Plan aims to increase capacity to 321 by end-2021 and to 446 in the longer term. Funding of €52m provided for 2021 will see the 40 beds provided in 2020 retained permanently and a further 26 added, to bring permanent baseline capacity to 321 by the end of 2021. The HSE has advised that 42 of these 66 beds are now open, bringing baseline capacity to 297, with the number open on any particular day fluctuating as a result of a variety of factors.
The details requested by the Deputy in relation to the number of beds across all types of hospitals (i.e., including non-acute beds), the number of mental health beds, and the overall capacity of the healthcare service are operational matters and require information to be provided by 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.
2589. Deputy Peadar Tóibín asked the Minister for Health the estimated cost of adding additional hospital beds, ICU and critical care beds and mental health beds to the health service by the individual cost of each bed. [38295/21]
View answerSeveral factors determine the capital cost of a bed. These include the nature of the bed (day case, long-term stay, etc.), and the bed’s location (within an existing facility, within a new extension to an existing facility, etc.). As such, there is no one capital cost for providing an additional bed.
A recent review of bed costings determined an average capital cost per bed to be in the region of:
Non Acute Bed - €0.35m to €0.45m
Acute Bed - €0.50m - €0.8m
Critical Care Bed - €1.40m to €1.80m
The estimates exclude any significant enabling works e.g. decant costs as well as other accommodation that may be required to support this additional capacity e.g. diagnostics, theatre space etc. Capital costs are naturally subject to variations with some sites requiring more investment depending on location, project scale, complexity of the site, existing infrastructure, site conditions, design etc. Costs per bed will vary depending on the size of the proposed development. Economies of scale would impact on the per bed cost.
2591. Deputy Peadar Tóibín asked the Minister for Health the estimated cost of establishing additional CAMHS units by unit. [38297/21]
View answerIt is not possible to provide a cost on a 'CAMHS Unit. The costs for such a unit will depend entirely on the size of the unit, location, associated services required etc. In addition the cost of such a unit must be considered in terms not only of the build costs but also in terms of the cost of staffing and running such a unit. Again the scale of the unit proposed is an obvious factor.
In terms of previous such projects being progressed by the HSE, a 22 bed residential unit (including a school) was completed for a total project cost of €14.54m. the base date for these costs was approximately 2013 which would give an approximate current day cost of €22m with a base date of Q2 2020.
2592. Deputy Neasa Hourigan asked the Minister for Health the current guidance to public health nurses on conducting development checks for new babies and mothers; if the service is still fully available; and if he will make a statement on the matter. [38298/21]
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.
2593. Deputy Carol Nolan asked the Minister for Health if he will provide an update on his Department's 2021 output target to establish a nursing home expert panel and report with a view to developing a bill to enhance the regulation and oversight of nursing homes, including increased enforcement powers and the establishment of licensing framework for the professional home support providers; and if he will make a statement on the matter. [38299/21]
View answerIn August 2020, the Nursing Home Expert Panel (NHEP) report was published which contained 86 recommendations, across 15 thematic areas, many of which will require legislative measures to implement. HIQA also submitted a paper outlining a number of suggested amendments to the legislation governing the operation of designated centres for older people.
Having regard to the NHEP recommendations, learning from the pandemic and HIQA's suggested regulatory enhancements, the Minister for Health and I approved a two-phased approach to examining the legislation with a view to proposing enhancements to the primary and secondary legislation governing nursing homes.
It is envisaged that phase 1 will bring forward interim enhancements to the primary legislative framework to, amongst other things, enhance the governance and oversight of nursing homes and improve the reporting of key operational data to support national planning in an integrated way and improve the information available. In January 2021 the Government approved the inclusion of a Health (Amendment) Bill 2021 on its legislative agenda. It is expected that, subject to Government approval draft Heads of Bill will be published by the end of the year.
In addition, secondary legislation will be drafted to enhance the current regulations in relation to a number of areas including infection prevention and control, governance and management and staffing.
A bilateral project group, established in October 2020 and comprising representatives from the Department and HIQA, is supporting the legislative process.
A wider review of the regulatory framework, phase 2, will commence in the second half of 2022, taking into account a programme of longer-term strategic reform considerations arising from inter alia pandemic learning with a view to exploring moving towards a service licensing system. HIQA has been requested to undertake an up-to-date international evidence review of nursing home regulatory models to support and inform the wider review. Engagement between the Department and HIQA on the research proposal and methodology is ongoing.
In relation to the home support sector, the Department is currently developing a regulatory framework for home support providers with the aim of ensuring that all service users are provided with a standard, high quality level of care. This framework will comprise (i) primary legislation for the licensing of public and private home support providers; (ii) minimum requirements (regulations); and HIQA National Standards for Home Support Services.
On 27 April 2021, Government gave approval to draft a General Scheme and Heads of a Bill to establish a licensing framework for home support providers. This will be progressed as a priority by the Department with a view to bringing it through the Houses of the Oireachtas at the earliest opportunity.
It is expected that the primary legislation will give the Minister for Health the power to make regulations in respect of minimum requirements which will form the criteria against which a provider’s eligibility to hold a licence will be determined.
2594. Deputy Carol Nolan asked the Minister for Health if the recently announced reforms to the nursing home support scheme include any distinction between land which is farmed versus land which is leased; if so, the different treatments that would apply; and if he will make a statement on the matter. [38300/21]
View answer2595. Deputy Carol Nolan asked the Minister for Health if children of farmers that inherit land from a parent who has land and entitlements leased to a non-relative under the tax incentive scheme are to be afforded the same proposed three year capping at 7.5% as other inheritors whose parents did not lease out land under the recently announced reforms to the nursing home support scheme; and if he will make a statement on the matter. [38301/21]
View answerI propose to take Questions Nos. 2594 and 2595 together.
The Nursing Homes Support Scheme, commonly referred to as the Fair Deal Scheme, has been in operation for over 10 years and there is broad agreement that the Scheme operates well and continues to provide appropriate financial assistance where it is required.
However, it is recognised that the Act, as it was, did not place caps on the financial assessment of family owned and operated farms or businesses when calculating the means to pay for nursing home care. This placed a potentially onerous burden on family successors and could challenge the future viability of these productive assets.
Therefore, the Department of Health proposed a policy change to the Scheme, to cap contributions based on farm and business assets at three years where an appointed family successor commits to working the productive asset for a period of 6 years. To be considered for the 3-year cap, the proposed legislation requires that an asset owned by an applicant for the Scheme, or recently transferred to a family member, is a productive family asset that has been actively worked by a family member for a significant period of time in advance of the person entering care.
Where an applicant retired and ceased working the farm or business themselves prior to entering long-term care, it is expected that their partner or a family successor will have taken over from them. In order to acknowledge the fact that many older people will have reduced their engagement in the family farm or business, but that a successor may not have taken over immediately, it is only required that the farm or business was worked by the applicant, their partner, or a family successor, for three of the five years preceding admission to long-term care, and this time need not be continuous.
Although land mobility has been a policy objective of various agricultural reliefs since the 1990s, the policy intent of the Nursing Homes Support Scheme is to protect family farms and businesses that will remain within the family as a source of employment and income into the future, and to ensure the future viability of these productive assets. This policy would not be advanced if income from leasing arrangements was included in the cap.
There is no prohibition of leasing arrangements in the Bill and individuals who lease their farms can continue to avail of the Nursing Homes Support Scheme. However, as previously stated, assets that are leased will not be covered by the reliefs provided for under the new Act and both the value of these assets and the income derived from the leasing arrangements will continue to be assessed as part of the financial assessment for the scheme.
I am pleased to say that the Nursing Homes Support Scheme (Amendment) Bill has now passed all stages of the Dáil and Seanad, and was enacted last week. The Act is required to come into operation 90 days from its enactment; in October 2021.
2596. Deputy Carol Nolan asked the Minister for Health if he will address concerns in relation to a child (details supplied) who has been waiting six years for orthodontic treatment; and if he will make a statement on the matter. [38302/21]
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.
2597. Deputy Dessie Ellis asked the Minister for Health the number of psychologists currently assigned to the CAMHS team in Ballymun, Dublin; his plans to reassign any psychologist based there; when a replacement will be expected; and if he will make a statement on the matter. [38303/21]
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.
2598. Deputy Dessie Ellis asked the Minister for Health the variance to the budget by expense category of the new national children's hospital in tabular form in view of the reports that it is set to cost €1.7 billion, up from the original estimated cost of circa €400 million; and if he will make a statement on the matter. [38304/21]
View answerThe previous Government approved an investment decision of €1.433bn for the capital project, which is €450m more than advised to Government in April 2017. This includes all of the capital costs for the main hospital at St James's Hospital campus, the two Outpatient Departments and Urgent Care Centres at Connolly Hospital, Blanchardstown and Tallaght University Hospital campuses, equipment for the three sites, and the construction of the carpark and retail spaces.
In addition to the capital project there is a broader programme of activity including new ICT and electronic health record development, and the integration and transfer of the services of the three children’s hospitals to the new sites which will bring a total overall programme cost of €1.73bn.
There are several items not included in this figure as there was no price certainly for them and nor can there be for the duration of the project, including excessive construction inflation (>4%) and the impact of Covid-19.
The table below outlines in tabular format the variance to the provisional budget on 2017 to the current budget, approved in 2018.
Table 21: Escalation in costs of the National Children's Hospital by Item 2017-2018govacc.per.gov.ie/wp-content/uploads/Periodic-Report-No.6-Final-Oct-2018-May-2019.pdf
|
Item |
2017 Costs €m |
2018 Costs €m |
|
Decant |
16 |
14.5 |
|
Aspergillus |
6.8 |
5.8 |
|
Main NCH |
637 |
890 |
|
Less Value Engineering |
-66 |
|
|
Net Main NCH construction |
571 |
890 |
|
Outpatient & Urgent Care Centres |
38 |
53.4 |
|
Sub Total |
631.8 |
963.7 |
|
VAT |
85.3 |
130.1 |
|
Gross Construction Costs |
717.1 |
1093.8 |
|
Equipping |
71.6 |
87.9 |
|
Planning |
14.9 |
13.6 |
|
Design Team Fees |
43.7 |
71.3 |
|
Risk/Contingency |
39 |
51.3 |
|
NPH Project costs |
52 |
66.04 |
|
Other Costs Sub Total |
221.1 |
290.1 |
|
VAT (excluding construction) |
44.7 |
49 |
|
Sub Total Gross Other Costs |
265.9 |
339.1 |
|
Capital Build Sub Total |
983 |
1.433bn |
|
Children's Research & Innovation Centre |
86 |
86 |
|
ICT |
88 |
97 |
|
Children's Hospital Integration Programme |
86 |
86 |
|
Electronic Healthcare Record |
52 |
52 |
|
Mater Campus |
40 |
40 |
|
Sub Total |
284 |
293 |
|
Grand Total |
1.26bn |
1.7bn |
2599. Deputy Catherine Connolly asked the Minister for Health the terms of reference of the review of the Health (Regulation of Termination of Pregnancy) Act 2018; the membership of the review group; when it is anticipated that the review will be published; and if he will make a statement on the matter. [38305/21]
View answer2650. Deputy Holly Cairns asked the Minister for Health the details of the review of the Health (Regulation of Termination of Pregnancy) Act 2018, which is due to take place not later than three years after its commencement under section 7 of the Act; the format this review will take; and if he will make a statement on the matter. [38649/21]
View answer2933. Deputy David Cullinane asked the Minister for Health the status of the review of the Health (Regulation of Termination of Pregnancy) Act 2018; if an independent expert has been appointed; if any of the strands have begun; if not, when each of the strands will begin; and if he will make a statement on the matter. [39662/21]
View answerI propose to take Questions Nos. 2599, 2650 and 2933 together.
The Health (Regulation of Termination of Pregnancy) Act 2018 was signed into law on 20 December 2018 and commenced on 1 January 2019. Section 7 of the Act states that “The Minister shall, not later than 3 years after the commencement of this section, carry out a review of the operation of this Act”.
The review is being progressed this year. At this stage I anticipate that the review will take a three-part approach to reviewing the operation of the Act, with strands focusing on service users, service providers and a public consultation.
Research to inform the service user and service provider strands will be commissioned and carried out independently, and a public consultation will be held.
Upon completion, a full report with any necessary recommendations, will be submitted to me, as Minister, for consideration.
2600. Deputy Peadar Tóibín asked the Minister for Health the staffing levels in each department at Navan Hospital including the emergency department in February 2020; and if he will provide a detailed account of the month-on-month reduction in staff numbers and healthcare services over the past seven months. [38285/21]
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.
2601. Deputy Pádraig O'Sullivan asked the Minister for Health the progress being made in relation to making zolgensma gene therapy available in Ireland; the outcome of the health technology assessment; and if he will make a statement on the matter. [38330/21]
View answer2786. Deputy Aindrias Moynihan asked the Minister for Health when zolgensma gene therapy will be approved for reimbursement for the treatment of spinal muscular atrophy; and if he will make a statement on the matter. [39158/21]
View answerI propose to take Questions Nos. 2601 and 2786 together.
The HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drugs schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.
In line with the 2013 Health Act and the national framework agreed with industry, if a company would like a medicine to be reimbursed by the HSE, the company must submit an application to the HSE to have the new medicine added to the reimbursement list. Reimbursement is for licensed indications which have been granted market authorisation by the European Medicines Agency or the Health Products Regulatory Authority.
In making a relevant reimbursement decision, the HSE is required under the Act to have regard to a number of criteria, including efficacy, the health needs of the public, cost effectiveness and potential or actual budget impact.
HSE decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds, on the advice of the National Centre for Pharmacoeconomics (NCPE).
I am advised by the HSE that, in April 2020, the NCPE received a reimbursement application dossier for Onasemnogene abeparvovec (Zolgensma). On 13 May 2020, the NCPE completed a rapid review with respect to this application and recommended a full Health Technology Assessment (HTA) to assess the clinical effectiveness and cost effectiveness of Zolgensma compared with the current standard of care.
The HTA was undertaken as a part of the Beneluxa collaboration between Ireland, the Netherlands and Belgium, with Austria acting as a reviewer in the Belgian procedure.
The HTA was completed in May 2021 and pricing/reimbursement negotiations have commenced July 2021.
A final decision on the pricing/reimbursement application for Zolgensma will be made in accordance with the 2013 Health Act.
2602. Deputy Pauline Tully asked the Minister for Health the reason no pharmacy in west County Cavan has been allowed to join the vaccine roll-out scheme; the reason there is no centralised booking system within the pharmacy vaccine roll-out which has resulted in persons being able to book more than one slot on a waiting list; and if he will make a statement on the matter. [38333/21]
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.
