Tuesday, 27 Jul 2021

Vaccination Programme

Questions (2732)

Pa Daly

Question:

2732. Deputy Pa Daly asked the Minister for Health if the discrepancies between the names as they appear on passports and those on vaccination cards or medical records will be resolved for the purposes of the EU Digital COVID Certificate. [38932/21]

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Written answers

Minister for Health

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.

Certificates based on vaccination and recovery are now being issued. Citizens who have not received their Digital COVID Certificate and require it urgently to travel in the coming days can call the helpline on 1800 807 008. Certificates based on negative PCR and antigen tests for travel within the EU can be obtained from private testing services signed up to the Digital Covid Test Certificate Service.

Every effort has been made to ensure the data on EU Digital Covid Certificates is correct and complete. For citizens who have a concern about the detail on your Digital COVID Certificate, they can call the helpline on 1800 807 008 to have the details corrected.

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.

Dental Services

Questions (2733)

Róisín Shortall

Question:

2733. Deputy Róisín Shortall asked the Minister for Health if a copy will be provided of the 2015 Report on the review of the statement of concern that children had been damaged by the HSE Orthodontic Services in Dublin Mid-Leinster (details supplied) the publication of which has been outstanding for over six years; the reason the publication has been delayed for so long; and if he will make a statement on the matter. [38933/21]

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Written answers

Minister for Health

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.

Medicinal Products

Questions (2734)

Aodhán Ó Ríordáin

Question:

2734. Deputy Aodhán Ó Ríordáin asked the Minister for Health if information will be provided on the efficacy or otherwise of the drug ivermectin as a treatment for Covid-19 and its potential utility or otherwise as an addition to the current highly effective vaccination programme. [38938/21]

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Written answers

Minister for Health

The Deputy is advised that, previously at the request of the NPHET, HIQA conducted a rapid evidence review to identify studies on the effectiveness of (i) pharmaceutical and (ii) non-pharmaceutical interventions, in the ambulatory setting, aimed at reducing progression to severe disease in individuals with confirmed or suspected COVID-19. This evidence review included a review of relevant studies in relation to Ivermectin.

As confirmed by HIQA’s COVID-19 Expert Advisory Group (www.hiqa.ie/sites/default/files/2021-02/Interventions-to-prevent-progression_Advice.pdf), evidence regarding the effectiveness of pharmaceutical treatments intended for systemic use, must be subject to the highest standards of rigour. Where a pharmaceutical intervention is recommended in the absence of appropriate supportive evidence, there is a significant potential for harm to the patient. Whereas this risk of harm may be justified in certain circumstances (e.g. the intervention poses minimal risk, or the setting involves patients with high potential to gain due to almost certain risk of severe adverse consequences in absence of any intervention) this is less likely to be the case in the setting of mild disease, where a great number of otherwise well patients would potentially receive the intervention.

HIQA has also advised my Department that several international health technology assessment or guideline development organisations have specifically reviewed the evidence to date on ivermectin in COVID-19 and have cautioned or advised against the use of ivermectin outside the setting of clinical trials on the basis of the current evidence. HIQA has also advised that the pharmaceutical company MSD (Merck, USA), which holds a license in the USA for the use of ivermectin as an antiparasitic agent, on 4 February 2021 published a statement including the following:

“It is important to note that, to-date, our analysis has identified:

- No scientific basis for a potential therapeutic effect against COVID-19 from pre-clinical studies;

- No meaningful evidence for clinical activity or clinical efficacy in patients with COVID-19 disease, and;

- A concerning lack of safety data in the majority of studies.

We do not believe that the data available support the safety and efficacy of ivermectin beyond the doses and populations indicated in the regulatory agency-approved prescribing information.”

Further research was undertaken by HIQA and updated advice was provided to the NPHET on 12 May: COVID-19 - Interventions and health related factors that prevent infection or minimise progression to severe disease. This document was subsequently published by HIQA on the 23 June 2021: www.hiqa.ie/sites/default/files/2021-06/Advice-to-NPHET_Interventions-to-prevent-COVID-19.pdf.

One of the key findings of the review was that Ivermectin is not currently licensed for the treatment of COVID-19. From this evidence summary, there is currently insufficient information on whether it can be safely used to prevent or reduce the severity of COVID-19. Ivermectin should therefore not be used as prophylaxis outside well-designed, regulated clinical trials as the benefits and harms are not yet clear when taken in the context of COVID-19 treatment.

Low certainty or very low certainty evidence was identified in relation to a small number of interventions. However, HIQA noted the low quality of the evidence available including the high risk of bias, small sample sizes and short durations of follow-up, different trials and advised that results from these studies should not be used to inform decision-making with respect to effectiveness.

HIQA’s overall finding was that there is currently insufficient evidence of either effectiveness or safety to support the use of any pharmaceutical intervention outside of well conducted, well-regulated clinical trials. Furthermore, no evidence was identified for the effectiveness or safety of any non-pharmaceutical interventions.

I trust that the above information satisfactorily addresses your question.

Healthcare Policy

Questions (2735, 3171)

Darren O'Rourke

Question:

2735. Deputy Darren O'Rourke asked the Minister for Health the status of Ireland’s progress on implementing via legislation the WHO Code of Marketing on Breast-milk Substitutes; and the reason there has been limited progress made in this regard since 2013. [38447/21]

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Jennifer Whitmore

Question:

3171. Deputy Jennifer Whitmore asked the Minister for Health the status of Ireland’s progress on implementing, via legislation, the WHO Code of Marketing on Breast-Milk Substitutes; the reason there has been no progress made in this regard since 2013; his views on the reasons for the delay in adopting into domestic law the provisions of the WHO code in its entirety; and if he will make a statement on the matter. [40574/21]

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Written answers

Minister of State at the Department of Health

I propose to take Questions Nos. 2735 and 3171 together.

As the HSE Breastfeeding Action Plan 2016-2021 is 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.

I can say however that promoting an increase in the number of new mothers breastfeeding is a priority in the Healthy Ireland Strategic Action plan 2021-2025. Infant formula is needed as not all babies are breastfed. 2021 is the year of the 40th anniversary of the adoption of the International Code of Marketing of Breast Milk Substitutes which is aimed at protecting children and families from inappropriate marketing of breastmilk substitute products. The Code covers infant formula products up to the age of 3 years.

My Department works closely with the HSE National Breast Feeding Co-ordinator, who has responsibility for the implementation of the HSE Breastfeeding Action Plan 2016-2021. I have been advised that the HSE has established the National Breastfeeding Implementation Group to progress the actions. One of these is reviewing the Code of Marketing of Breast Milk Substitutes in public health services and this is at final draft stage and is due for implementation, across all health services in 2021.

Home Care Packages

Questions (2736)

Bernard Durkan

Question:

2736. Deputy Bernard J. Durkan asked the Minister for Health the extent to which appropriate care at home or in hospital can be provided in the case of a person (details supplied); and if he will make a statement on the matter. [38985/21]

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Written answers

Minister of State at the Department of Health

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.

Health Services

Questions (2737)

Bernard Durkan

Question:

2737. Deputy Bernard J. Durkan asked the Minister for Health the steps that can be taken or are being taken to ensure the restoration of speech and language, occupational therapy or other therapies to meet the needs of a person (details supplied); and if he will make a statement on the matter. [38986/21]

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Written answers

Minister of State at the Department of Health

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.

Hospital Facilities

Questions (2738, 2742)

Rose Conway-Walsh

Question:

2738. Deputy Rose Conway-Walsh asked the Minister for Health the expected date of completion of the 50 bed ward brief isolation rooms at Mayo University Hospital; if he will provide a copy of the prepared brief; and if he will make a statement on the matter. [38990/21]

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Rose Conway-Walsh

Question:

2742. Deputy Rose Conway-Walsh asked the Minister for Health the expected date of completion of the upgrade of the ICU at Mayo University Hospital; if he will provide a copy of the prepared brief; and if he will make a statement on the matter. [38994/21]

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Written answers

Minister for Health

I propose to take Questions Nos. 2738 and 2742 together.

Minister for Health

The HSE's National Cancer Control Programme (NCCP) advise that the scheduled replacement of the air handling unit and doors pertains to the proactive maintenance and replacement of existing equipment in the aseptic compounding unit in the pharmacy department at Mayo University Hospital.

Minister for Health

I have been advised by HIQA that they confirm that the service providers mentioned in the details supplied have yet to be inspected to date in 2021.

In addition, HIQA have advised that their routine schedule of inspection in HSE run services have been adversely impacted by the third wave of the COVID-19 pandemic as well as the HSE cyberattack in May.

I have been advised by HIQA’s that it is their intention to carry out inspections of these facilities in the coming months. One finalised, inspection reports are published by HIQA on their website.

Hospital Waiting Lists

Questions (2748)

Rose Conway-Walsh

Question:

2748. Deputy Rose Conway-Walsh asked the Minister for Health the waiting lists for primary medical certificates by county in tabular form; and if he will make a statement on the matter. [39000/21]

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Written answers

Minister of State at the Department of Health

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.

Hospital Waiting Lists

Questions (2749)

Rose Conway-Walsh

Question:

2749. Deputy Rose Conway-Walsh asked the Minister for Health the number of persons waiting and average wait times for orthopaedic treatment on a county basis by type of treatment; and if he will make a statement on the matter. [39001/21]

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Written answers

Minister for Health

It is recognised that waiting times for scheduled appointments and procedures have been impacted in the last sixteen months as a direct result of the COVID-19 pandemic and more recently as a result of the ransomware attack.

While significant progress was made in reducing waiting times from June 2020 onwards, the surge in Covid-19 cases in the first quarter of 2021, and the resultant curtailment of acute hospital services, is reflected in the most recently available waiting list figures to 13th May 2021.

On 23 March 2021 the HSE published the “Safe Return to Health Services Plan”, outlining a three phased approach for the proposed restoration of services across Community Services, Acute Hospital Operations, Cancer Services and Screening Services. It sets target times for their safe return and details the conditions and challenges that will have to be met. However, the implementation of this plan was suspended pending the resolution of the recent ransomware attack, which had a significant impact on acute hospitals.

The HSE has been working since 14th May last to recover the effects of the cyber attack on its systems. The HSE advise that at present most systems are operational and services are returning to normal activity. There is a challenge in back entering data and there are still a number of areas of ongoing concern. The HSE was already seeking to recover from the Covid peak in the first quarter of this year and the ransomware attack has delayed this and had the effect of increasing access delays for services.

At the 13th of May 2021, nationwide there were 11,073 patients waiting for an adult or child orthopaedic IPDC procedure, a reduction of 19% (-2,569) compared to the same period last year.

Specifically in terms of hip and knee replacements, the National Treatment Purchase Fund (NTPF) have advised the Department that at the end of May 2020 there were 3,042 patients waiting for such a procedure. Through focused activity, and with the support of the NTPF, at the 13th May 2021 this figure had fallen by 26 % to 2,256 patients.

The NTPF have advised that they have provided funding for a number of Insourcing initiatives to reduce Orthopaedic waiting lists in 2021, which will see 15,385 patients receive appointments and procedures.

An additional €240 million has been provided in Budget 2021 for an access to care fund, €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 working on a Multiannual Waiting List Plan to address waiting lists and bring them in line with Sláintecare targets over the coming years.

The information requested by the Deputy concerning the number of persons waiting and average wait times for orthopaedic treatment on a county basis by type of treatment is outlined in the attached document.

Due to the ongoing IT issues triggered by the HSE cyber-attack, the NTPF has been unable to receive weekly national hospital waiting list data or downloads. The latest published waiting list information was collated by the NTPF on 13th May 2021.

The NTPF has advised that the health system does not collect the data necessary to calculate average wait times. In particular, the time to treatment of patients who have already received their care is not collected. The NTPF collects data on patients currently on the waiting list and the average time that these patients have been waiting is provided here.

Total IPDC Waiters for an Orthopaedic Procedure by Area of Residence by Wait Time Band as at 13/05/2021
Sum of Total	Column Labels
Row Labels	0-6 Mths	6-12 Mths	12-18 Mths	18+ Mths	Small Vol Time Band	Grand Total
Carlow	46	20	13	16		95
Cavan	80	14	5	14		113
Clare	121	80	35	18		254
Cork	229	79	46	28		382
Donegal	288	282	170	164		904
Dublin	1593	506	313	489		2901
Exception	280	51	36	38		405
Galway	339	157	146	252		894
Kerry	165	42	50	13		270
Kildare	293	113	94	136		636
Kilkenny	45	22	15	16		98
Laois	163	29	25	42		259
Leitrim	54	22	21	16		113
Limerick	204	149	71	19		443
Longford	72	15	18	37		142
Louth	55	15	11	19		100
Mayo	266	130	88	184		668
Meath	135	24	27	21		207
Monaghan	22	8				30
Offaly	164	36	35	73		308
Roscommon	79	43	36	64		222
Sligo	186	77	49	43		355
Small Vol Area					7	7
Tipperary	165	74	32	22		293
Waterford	95	18	17	13		143
Westmeath	172	33	33	65		303
Wexford	162	38	23	38		261
Wicklow	156	46	29	36		267
Grand Total	5629	2123	1438	1876	7	11073

Dental Services

Questions (2750)

Rose Conway-Walsh

Question:

2750. Deputy Rose Conway-Walsh asked the Minister for Health the number of dentists in the dental treatment services scheme for each year since 2016, by county; and if he will make a statement on the matter. [39002/21]

View answer

Written answers

Minister for Health

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.

Hospital Waiting Lists

View answer

Written answers

Minister for Health (Deputy Stephen Donnelly)

I propose to take Questions Nos. 2751 to 2754, inclusive, and 2757 together.

It is recognised that waiting times for scheduled appointments and procedures have been impacted in the last sixteen months as a direct result of the COVID-19 pandemic and more recently as a result of the ransomware attack.

While significant progress was made in reducing waiting times from June 2020 onwards, the surge in Covid-19 cases in the first quarter of 2021, and the resultant curtailment of acute hospital services, is reflected in the most recently available waiting list figures to 13th May 2021.

On 23 March 2021 the HSE published the “Safe Return to Health Services Plan”, outlining a three phased approach for the proposed restoration of services across Community Services, Acute Hospital Operations, Cancer Services and Screening Services. It sets target times for their safe return and details the conditions and challenges that will have to be met. However, the implementation of this plan was suspended pending the resolution of the recent ransomware attack, which had a significant impact on acute hospitals.

The HSE has been working since 14th May last to recover the effects of the cyber attack on its systems. The HSE advise that at present most systems are operational and services are returning to normal activity. There is a challenge in back entering data and there are still a number of areas of ongoing concern. The HSE was already seeking to recover from the Covid peak in the first quarter of this year and the ransomware attack has delayed this and had the effect of increasing access delays for services. My Department does not have full access to information on the impact of this ransomware attack on elective waiting lists but will provide an update as soon as one is available.

An additional €240 million has been provided in Budget 2021 for an access to care fund, €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 National Treatment Purchase Fund (NTPF) are currently working on a Multiannual Waiting List Plan to address waiting lists and bring them in line with Sláintecare targets over the coming years.

Due to the ongoing IT issues triggered by the HSE cyber-attack, the NTPF has been unable to receive weekly national hospital waiting list data or downloads. The latest published waiting list information was collated by the NTPF on 13th May 2021.

The NTPF has advised that the health system does not collect the data necessary to calculate average wait times. In particular, the time to treatment of patients who have already received their care is not collected. The NTPF collects data on patients currently on the waiting list and the average time that these patients have been waiting is provided here.

The information requested by the Deputy is outlined in the attached documents. This information includes

- The number of children on the waiting list to see a paediatrician on a county basis and the duration of time waiting in three month blocks.

- The number of children awaiting an outpatient appointment at Mayo University Hospital and University Hospital Galway; the comparison to the same period in 2019.

- The number of children on the waiting list to see a paediatrician in County Mayo.

- The wait time for outpatient appointments at Mayo University Hospital and University Hospital Galway.

-The number of persons waiting on lists as both inpatients and outpatients for Mayo University Hospital; the average wait time; the number waiting more than one, two, three and four years.

Children Waiting for an Outpatient Appointment in Mayo and Galway University Hospitals 2019 v 2021
Sum of Total	Column Labels
Row Labels	30/05/2019	13/05/2021
Galway University Hospitals	4589	4870
Mayo University Hospital	1540	1522
Grand Total	6129	6392

Total OP Paediatric Waiters for a Paediatric Consultant by Area of Residence by Wait Time Band as at 13/05/2021
Sum of Total	Column Labels
Row Labels	0-3 Months	3-6 Months	6-9 Months	9-12 Months	12-15 Months	15-18 Months	18 Months +	Grand Total
Carlow	208	81	71	45	30	20	104	559
Cavan	203	105	62	37	26	44	108	585
Clare	126	84	48	24	21	19	17	339
Cork	981	495	313	182	159	198	301	2629
Donegal	414	226	141	68	39	33	66	987
Dublin	4375	2564	2065	1184	1049	1378	5546	18161
Exception	188	88	67	39	26	21	118	547
Galway	481	359	198	100	117	78	153	1486
Kerry	253	130	97	66	54	70	70	740
Kildare	770	387	326	219	179	188	867	2936
Kilkenny	209	71	46	30	25	17	61	459
Laois	232	132	102	74	60	55	161	816
Leitrim	62	33	29	21	15	10	23	193
Limerick	267	159	101	37	34	26	35	659
Longford	120	54	28	9	12	17	59	299
Louth	419	293	243	118	103	142	309	1627
Mayo	250	136	41	35	16	17	43	538
Meath	612	399	335	183	129	155	559	2372
Monaghan	142	74	57	37	36	34	78	458
Offaly	170	88	73	59	33	30	93	546
Roscommon	128	95	40	26	24	18	42	373
Sligo	173	90	86	51	48	43	52	543
Tipperary	282	142	119	39	27	24	55	688
Waterford	241	151	104	59	63	50	65	733
Westmeath	225	108	94	54	35	43	126	685
Wexford	409	201	96	49	52	37	167	1011
Wicklow	438	248	185	122	86	105	496	1680
Grand Total	12378	6993	5167	2967	2498	2872	9774	42649

Mayo University Hospital Outpatient Waiting List
0-3Months	3-6Months	6-9Months	9-12Months	12-15Months	15-18Months	18-21Months	21-24Months	24-36Months	36-48Months	48+Months	Grand Total
2367	1858	1742	1228	955	821	620	589	1823	932	1016	13951
Galway University Hospital Outpatient Waiting List
0-3Months	3-6Months	6-9Months	9-12Months	12-15Months	15-18Months	18-21Months	21-24Months	24-36Months	36-48Months	48+Months	Grand Total
11140	7254	6737	4656	3359	4497	4014	3165	7053	2780	1188	55843

OP Waiters in Mayo University Hospital as of 13/5/2021
Sum of Amount	Column Labels
Row Labels	< 1 year	< 2 years	< 3 years	< 4 years	4+ years	Small Volume TimeBands	Grand Total
General Medicine	1675	914	485	289	124		3487
General Surgery	1939	809	302				3050
Geriatric Medicine	89						89
Gynaecology	588	9					597
Nephrology	61	30	29	31	29		180
Orthopaedics	1792	418	113	70			2393
Otolaryngology (ENT)	470	560	634	343	630		2637
Paediatrics	289						289
Small Volume Specialties						6	6
Urology	107	79	54	69	91		400
Mean NumDays:	531
Median NumDays:	342

Question No. 2752 answered with Question No. 2751.

Question No. 2753 answered with Question No. 2751.

Question No. 2754 answered with Question No. 2751.