Written Answers Nos. 2603-2621
2603. Deputy Catherine Connolly asked the Minister for Health his plans for the establishment of a public inquiry into each individual death from Covid-19 in nursing homes as recommended by the Houses of the Oireachtas Special Committee on Covid-19 Response; and if he will make a statement on the matter. [38334/21]
View answerThe Health Information and Quality Authority, HIQA, is the statutory independent regulator in place for the nursing home sector, whether a HSE managed or a private nursing home. The Authority, established under the Health Act 2007, has significant and wide-ranging powers up to and including withdrawing the registration of a nursing home facility, which means that it can no longer operate as a service provider. This responsibility is underpinned by a comprehensive quality framework comprising of Registration Regulations, Care and Welfare Regulations and National Quality Standards.
HIQA, in discharging its duties, determines through examination of all information available to it, including site inspections, whether a nursing homes meets the regulations in order to achieve and maintain its registration status. Should a nursing home be deemed to be non-compliant with the Regulations and the National Quality Standards, it may either fail to achieve or lose its registration status. In addition, the Chief Inspector has wide discretion in deciding whether to impose conditions of Registration on nursing homes.
The Deputy will be aware that the Nursing Homes Expert was established, on foot of a NPHET recommendation, to examine the complex issues surrounding the management of COVID-19 among this particularly vulnerable cohort. This Expert Panel report has added further to our knowledge and learning. This report clearly outlines the key protective measures that we must ensure are in place across our nursing homes. These actions are based on learning from our own and the international experience of COVID-19 to date. The report also recommends additional analysis and examination of the relevant public health and other data sets in order that further causal and protective factors for COVID-19 clusters are identified. HIQA and the Health Protection Surveillance Centre (HPSC) recently jointly published an “Analysis of factors associated with outbreaks of SARS-CoV-2 in nursing homes in Ireland”, delivering on recommendation 6.7 of the Expert Panel report, to further the learning from the pandemic. Further data analysis work and learning will also continue, in line with other recommendations of the Expert Panel, although these have been affected by the recent cyberattack on the health system.
Work to progress the recommendations of the Expert Panel report, particularly those recommendations requiring a priority focus in the response to COVID-19, is ongoing across all of the health agencies and stakeholders. Continued learning and understanding of progression of the disease in Ireland is an integral part of those recommendations.
At a broader level, there has been significant and ongoing consideration of this impact since the start of the pandemic, with various examinations and development of reports with a focus on COVID-19, its impact on nursing homes and the pandemic learnings that can inform future policy, regulation and the model of care for older persons. There has been a very clear national commitment to continue to learn from the pandemic as the national and international understanding of the virus evolves, and where necessary to ensure that the public health-led approach evolves, as evidence and learning materialises. Findings of these reports confirm that the very infectious nature of COVID-19 makes it difficult to prevent and control in residential care settings. The reports produced nationally identify findings consistent with international evidence, which have highlighted that the probability of COVID-19 introduction into nursing home depends on the levels of the disease circulating in the community, with a higher risk associated with higher incidence rates in the community.
While significant progress is being made in relation to the roll-out of the vaccination programme, and the current situation in nursing homes is broadly stable, the prevalence of the more transmissible Delta variant is rapidly increasing in Ireland and this poses a significant risk, in particular to those who are not yet fully protected though vaccination. It must be recognised that the pandemic has not concluded and at this time a priority focus of Government remains on the ongoing management of the COVID-19 response, to ensure that the positive gains now been experienced are preserved, and that those most vulnerable to the virus continue to be safeguarded, having regard to the residual risk.
I am very aware that there are many situations where we can learn by listening to families. While we are still dealing with a degree of risk in nursing homes due to COVID-19, we are continuing to look at options which may be available to the State in relation to listening to the voices of those who have lost a loved one.
2605. Deputy Thomas Gould asked the Minister for Health the reason for suspending activity of the North Inner City Drug and Alcohol Taskforce. [38345/21]
View answer2666. Deputy Gary Gannon asked the Minister for Health if he will elaborate on the governance shortcomings in the operations of the North Inner City Drug and Alcohol Taskforce communicated in a letter (details supplied) to members of the taskforce; and if he will make a statement on the matter. [38696/21]
View answer2667. Deputy Gary Gannon asked the Minister for Health the legal basis for the suspension of the North Inner City Drug and Alcohol Task Force; and if he will make a statement on the matter. [38697/21]
View answer2672. Deputy Patrick Costello asked the Minister for Health the specific points upon which the suspension of the North Inner City Drugs and Alcohol Task Force is based; the evidence which has been used for same; and if he will make a statement on the matter. [38738/21]
View answer2686. Deputy Paul Donnelly asked the Minister for Health the reason his Department suspended the activities of the North Inner City Drugs and Alcohol Task Force and is putting in place its own process to appoint a chairperson and to broaden the membership of the task force; and if he will make a statement on the matter. [38785/21]
View answer3049. Deputy Neasa Hourigan asked the Minister for Health the governance shortcomings in the North Inner-City Drug and Alcohol Task Force that his Department has recently identified; and if he will make a statement on the matter. [40103/21]
View answerI propose to take Questions Nos. 2605, 2666, 2667, 2672, 2686 and 3049 together.
Drug and Alcohol Task Forces play a key role in the implementation of the national drugs strategy, Reducing Harm Supporting Recovery 2017-2015. Action 50 in the strategy seeks to improve accountability across the statutory, community and voluntary sectors and strengthen the task force model. This action will be delivered by ensuring that task forces have proper arrangements in place for the selection and renewal of the chairperson and members of the task forces and have proper procedures in place for addressing conflicts of interest.
The task force handbook sets out the chairperson’s role to lead the task force and to facilitate its meetings.. The chairperson’s independence must clearly be established and evident in the manner in which the business of the task force is conducted. It is important therefore, that the chairperson appointed by the task force is not directly connected with any of the projects being funded by the task force. It is also important that there is complete transparency in the arrangements put in place by task forces for the selection process and appointment of the chairperson.
The North Inner City Drug and Alcohol Task Force has an annual allocation of €2.2 million in funds from the Department of Health. The Department has worked very cooperatively with the task force in recent years to enhance its contribution to the North East Inner City Initiative. At the start of 2021, the outgoing chairperson of the task force and the Department agreed arrangements to be put in place for the selection and appointment of the chairperson. Regrettably, the agreed process for selecting and appointing an independent chairperson was not followed. The Department wrote to the task force to highlight its concerns and to invite the task force to engage with the Department on this matter.
I strongly believe that it is the collective membership of the task force alone that should appoint a chairperson, and not the limited company associated with the task force. I ask for the cooperation of all stakeholders to put in place appropriate governance procedures for the North Inner City task force.
2608. Deputy Róisín Shortall asked the Minister for Health his estimate of the cost in 2022 and in a full year of ensuring that staff working in the 300 section 39 organisations covered under pay restoration have their pay raised to parity with equivalent workers in public sector and section 38 organisations. [38360/21]
View answerSection 39 agencies are agencies under Section 39 of the Health Act 2004 where the HSE provides a grant to allow the agency to provide services similar or ancillary to the HSE. Staff in these section 39 organisations were not subject to the provisions of FEMPI legislation and therefore did not receive those cuts that were applied to the pay of public servants. They were not and are not party to the Public Service Agreements and are therefore not covered by the pay restoration provided for in these Agreements. While it is understood that pay savings were made by the organisations, the precise mix of pay cuts or other savings measures will have varied.
In October 2018, an agreement was reached by the parties at the Workplace Relations Commission in relation to a process of pay restoration for staff employed in a pilot group of 50 section 39 organisations who are funded by way of a Service Level Agreement (SLA). A further WRC engagement followed in December 2020 in relation to a final phase of 250 SLA funded organisations who were identified as part of the earlier agreement.
Pay restoration was applicable to Section 39 organisations who met certain criteria, rather than types of individual workers that are employed in them. The list of section 39 organisations that was compiled, included only agencies that had service arrangements in place back in 2013 and that were still under service arrangements in 2019. Only organisations who received in excess of an agreed, specified amount from the HSE by way of the SLA process were included.
It must be acknowledged that Section 39 organisations are privately owned and run and that their terms and conditions of employment, once in line with employment legislation, are strictly between the employer and the employee and lie beyond the remit of the Department of Health. It also should be acknowledged that the process agreed to was that of pay restoration of cuts that had been previously imposed and not pay parity for equivalent workers in public sector and section 38 organisations.
Pay restoration is absolutely limited and only applicable to those included in the initial WRC agreement. I can also confirm that there is no scope to revisit the eligibility criteria for the process and that the process has reached a final resolution.
2610. Deputy Pádraig Mac Lochlainn asked the Minister for Health the measures that will be put in place by his Department to ensure that cross-Border workers who availed of the Covid-19 vaccine in the Northern Ireland will be included in the roll-out of the EU Digital COVID Certificate in this State. [38363/21]
View answer2656. Deputy Pearse Doherty asked the Minister for Health if cross-Border workers vaccinated in the North will receive a European vaccine certificate; and if he will make a statement on the matter. [38663/21]
View answer2665. Deputy Brendan Smith asked the Minister for Health if persons resident in this State who have been fully vaccinated in Northern Ireland with a European Medicines Agency approved vaccine will be entitled to a vaccine certificate; and if he will make a statement on the matter. [38686/21]
View answer2862. Deputy Fergus O'Dowd asked the Minister for Health the process by which Irish citizens that reside in the Republic of Ireland but work in Northern Ireland and have been fully vaccinated in Northern Ireland can apply for the EU Digital COVID Certificate; and if he will make a statement on the matter. [39415/21]
View answer2885. Deputy Ged Nash asked the Minister for Health if Irish citizens and their family members who have been vaccinated in Northern Ireland will be eligible for the Digital COVID Certificate in (EU) 2021/953 (details supplied); and if he will make a statement on the matter. [39479/21]
View answer2988. Deputy Brendan Smith asked the Minister for Health the way in which cross-border workers who are residing in the Republic of Ireland but working in Northern Ireland and who have received their vaccinations in Northern Ireland can access the EU Digital COVID Certificate (details supplied). [39785/21]
View answer3289. Deputy Brendan Smith asked the Minister for Health if Irish citizens living in Northern Ireland that have been fully vaccinated with an approved EMA vaccine will be entitled to the EU Digital COVID Certificate; and if he will make a statement on the matter. [41267/21]
View answerI propose to take Questions Nos. 2610, 2656, 2665, 2862, 2885, 2988 and 3289 together.
The Digital COVID Certificate Regulation is intended to facilitate people’s fundamental right to move and reside freely and help to support the lifting of restrictions currently in place in a coordinated manner within the EU.
As the Minister for Health, I am supporting the work of my Department in collaborating with relevant Departments under the leadership of the Department of Taoiseach to assist in the on-going implementation of the EU Digital COVID Certificates.
Arrangements for provision of vaccination certificates to persons not vaccinated in Ireland, including Irish citizens vaccinated in Northern Ireland, will be considered once the initial roll-out is in place.
2611. Deputy Pádraig O'Sullivan asked the Minister for Health the details of the recommendation made by the HSE drugs group in its May 2021 meeting regarding the reimbursement of patisiran; and if he will make a statement on the matter. [38387/21]
View answer2613. Deputy Pádraig O'Sullivan asked the Minister for Health when the HSE executive management team will meet to consider the recommendation of the drugs group regarding the reimbursement application of patisiran; when the treatment will be made available to patients in Ireland; and if he will make a statement on the matter. [38397/21]
View answerI propose to take Questions Nos. 2611 and 2613 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, a company must submit an application to the HSE to have a 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. 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).
The HSE has advised that it received an application in December 2018 for the reimbursement of Patisiran (Onpattro) for the treatment of hereditary transthyretin-mediated amyloidosis (hATTR amyloidosis) in adult patients with stage 1 or stage 2 polyneuropathy.
In January 2019, a full health technology assessment (HTA) with respect to this indication was commissioned by the HSE. This assessment was completed in February 2020, with the NCPE recommending that Patisiran not be considered for reimbursement unless cost-effectiveness could be improved relative to existing treatments.
On 22 June 2021, following extensive engagement by the HSE with the applicant company, the HSE Executive Management Team considered the HSE Drugs Group recommendation with respect to Patisiran and have supported hospital pricing approval for the drug, subject to the implementation of a managed access programme.
The HSE further advises that they will now develop and implement the required managed access programme, in order for all eligible patients with hereditary transthyretin-mediated amyloidosis (hATTR amyloidosis) with stage 1 or stage 2 polyneuropathy to access treatment with Patisiran in the near future.
2612. Deputy Mark Ward asked the Minister for Health if Access to Psychological Service Ireland will be replicated in all CHO areas; if so, the CHO areas; if not, the reason; if it will be accessible to persons under 18 years of age; and if he will make a statement on the matter. [38390/21]
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.
2614. Deputy Michael Ring asked the Minister for Health when a system will be put in place to ensure more accurate vaccinations administered (details supplied); and if he will make a statement on the matter. [38399/21]
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.
2615. Deputy Kieran O'Donnell asked the Minister for Health if he plans to provide some of the anticipated 2021 cost savings from the recent HSE medicines management programme preferred blood glucose strips for adults with type 1 and type 2 diabetes evaluation to fund the provision of the FreeStyle Libre flash glucose monitoring system to persons with diabetes over 21 years of age based on clinical need; and if he will make a statement on the matter. [38402/21]
View answer2916. Deputy Paul Murphy asked the Minister for Health if he will ring-fence some of the anticipated 2021 cost savings from the recent HSE medicines management programme preferred blood glucose strips for adults with type 1 and 2 diabetes evaluation to fund the provision of the FreeStyle Libre flash glucose monitoring system to persons with diabetes over 21 years of age based on clinical need; and if he will make a statement on the matter. [39637/21]
View answerI propose to take Questions Nos. 2615 and 2916 together.
I have been advised by the HSE that the PCRS has been approached by the Diabetes Clinical Programme to progress the allocation of some of the efficiencies arising from the MMP preferred blood glucose strips for funding further priority groups with type 1 Diabetes. Such a consideration must be balanced with all of the exigencies placed on the PCRS to remain within their budget allocation for 2021 and remains under deliberation.
Consultant Endocrinologists / Diabetes Nurse Specialists may apply to the HSE, on behalf of specific patients, for reimbursement support of FreeStyle Libre Flash Glucose Monitoring (FGM) sensors. This includes those persons with eligibility under Community Drug Schemes (e.g. medical card holders, those with Long Term Illness eligibility). The application process is undertaken by means of a dedicated online portal, which has been operational since 3rd April 2018. In line with the recommendations outlined of the Health Technology Assessment Group, access to this product was made available to children and young adults (4 -21 years). However, the application process does cater for the Consultant to make an application in very exceptional circumstances for a type 1 diabetic patient outside of this group.
2616. Deputy Kieran O'Donnell asked the Minister for Health if a submission for funding to provide the FreeStyle Libre flash glucose monitoring system to persons with diabetes over 21 years of age based on clinical need in the National Service Plan 2021 was received from the HSE PCRS; and if he will make a statement on the matter. [38403/21]
View answer2617. Deputy Kieran O'Donnell asked the Minister for Health if he is expecting a submission for funding from the HSE PCRS to provide the FreeStyle Libre flash glucose monitoring system to persons with diabetes over 21 years of age based on clinical need for inclusion in the National Service Plan 2022.; and if he will make a statement on the matter. [38404/21]
View answer2618. Deputy Kieran O'Donnell asked the Minister for Health if he has received a submission from the HSE PCRS recommending that the FreeStyle Libre flash glucose monitoring system is made available to persons with diabetes over 21 years of age based on clinical need; and if he will make a statement on the matter. [38405/21]
View answerI propose to take Questions Nos. 2616 to 2618, inclusive, together.
I have not received a funding proposal from the HSE in relation to the FreeStyle Libre flash glucose monitoring system. I understand that the review process in relation to this product is not yet completed.
2619. Deputy Kieran O'Donnell asked the Minister for Health the number of meetings that have been held in 2020 and to date in 2021 between the manufacturers of the FreeStyle Libre flash glucose monitoring system and the HSE PCRS in relation to making the technology available to persons with diabetes over 21 years of age based on clinical need; the outcomes of these meetings; and if he will make a statement on the matter. [38406/21]
View answerThe HSE have advised that there have been three meetings held between the manufacturers of the Freestyle Libre system and the Primary Care Reimbursement Service in this timeframe. At the most recent meeting, the manufacturer confirmed that they held sufficient clinical evidence to support a full Health Technology Assessment (HTA) process.
The HSE has now commissioned a full HTA to be conducted by the National Centre for Pharmacoeconomics (NCPE) in collaboration with the Medicines Management Programme. The engagement with the NCPE has commenced as evidenced in recent days with a call for patient group submissions.
2621. Deputy John McGuinness asked the Minister for Health if the care needs and professional services required by a person (details supplied) will be provided by the HSE or sourced in the private sector and funded by the HSE; if an assessment for ASD will be arranged immediately; and if he will make a statement on the matter. [38410/21]
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.
