Written Answers Nos. 2918-2940
2918. Deputy Paul Murphy asked the Minister for Health if he will extend eligibility to the long-term illness scheme for reimbursement of blood glucose test strips to all women who develop gestational diabetes during pregnancy; his views on the decision to remove them from the scheme; if he will now reverse that decision; and if he will make a statement on the matter. [39639/21]
View answerThe Long Term Illness Scheme was established under Section 59(3) of the Health Act 1970 (as amended). The conditions covered by the scheme are: acute leukaemia; mental handicap; cerebral palsy; mental illness (in a person under 16); cystic fibrosis; multiple sclerosis; diabetes insipidus; muscular dystrophies; diabetes mellitus; parkinsonism; epilepsy; phenylketonuria; haemophilia; spina bifida; hydrocephalus; and conditions arising from the use of Thalidomide.
Under the Scheme, patients receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge.
Gestational diabetes is not a permanent or long-term illness and is, therefore, not covered by the Scheme. There are currently no plans to make specific provision for gestational diabetes under any new or existing health scheme.
However, there are other supports for access to medical approved items such as the Drug Payment Scheme (DPS) and the General Medical Services Scheme (GMS) that would assist patients with gestational diabetes.
Under the DPS, no individual or family pays more than €114 a month towards the cost of approved prescribed medicines. The scheme significantly reduces the cost burden for families and individuals with ongoing expenditure on medicines.
For people who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be eligible for a medical card. In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE. In certain circumstances the HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income guidelines, where he or she faces difficult financial circumstances, such as extra costs arising from illness.
The HSE afford applicants the opportunity to furnish supporting documentation to determine whether undue hardship exists and to fully take account of all relevant circumstances that may benefit them in assessment, including medical evidence of costs and certain expenses.
In circumstances where an applicant is still over the income limit for a medical card, they are then assessed for a GP visit card, which entitles the applicant to GP visits without charge.
Further information on the medical card scheme and the application process are available at: www.hse.ie.
Patients may also be entitled to claim tax relief on the cost of their medical expenses. This includes medicines prescribed by a doctor, dentist, or consultant. Relief is at the standard tax rate of 20%. Details on how to claim are at www.revenue.ie.
2919. Deputy Paul Murphy asked the Minister for Health if he will provide funding to appoint a clinical psychologist to each acute hospital diabetes multi-disciplinary team; his views on the fact that psychosocial support in diabetes care is not formally embedded as part of diabetes management; and if he will make a statement on the matter. [39640/21]
View answerDiabetes is a complex condition that can have a profound impact on the quality of life of people living with the condition, the management of emotional and psychological well-being is an important part of diabetes care and self-management. Self-management education programmes such as DAFNE (for people living with type 1 diabetes) and DESMOND and Discover Diabetes (for people living with type 2 diabetes) help provide psychosocial support for many people living with diabetes.
The Model of Integrated Care for Patients with Type 2 Diabetes sets out that diabetes is to be managed within the acute system by the diabetes multidisciplinary team including access to psychology support where available. However, I acknowledge there is a deficit in the number of hospital staff providing psychological services dedicated to diabetes care.
The 2021 National Service Plan recognised the need for an unprecedented expansion of the permanent health workforce through permanent appointments. Funding has been provided for an increase to approximately 135,655 WTE across the health service by December 2021, which is an increase of 15,838 WTE over funded 2020 levels. There is significant workforce recruitment underway. The HSE Pay and Numbers Strategy identifies the specific roles and grades to be hired.
2920. Deputy Paul Murphy asked the Minister for Health when the specialist community diabetes teams under the enhanced community care programme will be appointed; if it will be available to all persons with diabetes free of charge; and if he will make a statement on the matter. [39641/21]
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.
2921. Deputy Paul Murphy asked the Minister for Health his views on the need for a national diabetes register; the reason there is no current register; and if he will make a statement on the matter. [39642/21]
View answer3177. Deputy Cathal Crowe asked the Minister for Health if his Department will consider establishing a national diabetes register to track the prevalence of the condition, measure outcomes, ascertain cost of care and plan for future services; and if he will make a statement on the matter. [40581/21]
View answerI propose to take Questions Nos. 2921 and 3177 together.
In September 2019 Sláintecare Integration funding was allocated to the HSE to design and procure a National Diabetes Registry demonstrator product and develop a full specification plan for a National Diabetes Registry.
The development of a National Diabetes Registry will have a long-term benefit on:
- Patient care by facilitating benchmarking of individual care against guideline recommendations and QI feedback to practitioners
- Provision of appropriate health services by providing reliable information to healthcare planners and policymakers.
This project was paused as it was dependent on the input and expertise of key HSE staff who were redeployed onto urgent COVID-19 work and will be revisited again in the future.
2923. Deputy David Cullinane asked the Minister for Health the current supports available for nursing home residents to cover transportation costs for medical appointments; and if he will make a statement on the matter. [39644/21]
View answerThe Nursing Homes Support Scheme (NHSS), commonly referred to as Fair Deal, is a system of financial support for people who require long-term residential care. Participants contribute to the cost of their care according to their means while the State pays the balance of the cost.
The NHSS covers the cost of the standard components of long-term residential care which are:
- Nursing and personal care appropriate to the level of care needs of the person;
- Bed and board;
- Basic aids and appliances necessary to assist a person with the activities of daily living; and
- Laundry service.
Costs not covered by the NHSS include those individually incurred for items like social activities, newspapers and hairdressing. This may also include medical services such as therapies and some medical equipment. A person's eligibility for other schemes, such as the medical card scheme or the drugs payment scheme, is unaffected by participation in the NHSS or residence in a nursing home. In determining the services covered by the NHSS it was considered very important that the care recipient and the taxpayer would be protected and would not end up paying for the same services twice. For this reason, medications and aids that are already prescribed for individuals under an existing scheme are not included in the services covered by the NHSS, as this would involve effectively paying twice for the same service.
It is important to state that residents of nursing homes should enjoy the same levels of support and access to services as when they lived in their own homes. It is acknowledged that the reason they require 24 hour levels of support is due to their level of dependency, which in turn may require access to clinical services including hospital and other outpatient appointments in the community. The HSE provides for a level of Intermediate Care Vehicles, which are used predominantly for non-emergency transport between acute hospitals for admission and discharge purposes. They would be reserved for those who would need specific support in transport. In other cases, normal transport arrangements apply. These arrangements (e.g. wheelchair taxi) are normally funded by the individual.
Although the NHSS covers core living expenses, residents can still incur some costs in a nursing home, as set out above. In recognition of this, anyone in receipt of financial support under the NHSS retains at least 20% of their income. The minimum amount that is retained is the equivalent of 20% of the State Pension (Non-Contributory).
2926. Deputy Michael McNamara asked the Minister for Health if the full list of all section 39 agencies to which pay restoration applies including the smaller ones agreed at a recent conciliation conference held under the auspices of the Workplace Relations Commission will be provided; and if he will make a statement on the matter. [39655/21]
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. 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.
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 Service Level Agreement 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. Consequently, it would not be appropriate for the Department of Health to provide a list of which section 39 agencies applied for and/or received funding under the pay restoration agreement. Employees should be advised to raise the query with their employers to determine if their organisations were included in the agreement.
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.
2927. Deputy David Cullinane asked the Minister for Health the reason the National Ambulance Service does not recognise intermediate care operatives as ambulance personnel; and if he will make a statement on the matter. [39656/21]
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.
2928. Deputy David Cullinane asked the Minister for Health the reason the National Ambulance Service is asking intermediate care operatives to work on emergency ambulances; and if he will make a statement on the matter. [39657/21]
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.
2929. Deputy David Cullinane asked the Minister for Health the staffing levels of the National Ambulance Service by CHO; the current number of whole-time equivalent posts by occupation currently working; the recommended and budgeted number; and if he will make a statement on the matter. [39658/21]
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.
2930. Deputy David Cullinane asked the Minister for Health his plans for increasing National Ambulance Service whole-time equivalent staffing levels; and if he will make a statement on the matter. [39659/21]
View answerAs the Deputy may be aware, the Emergency Service Baseline and Capacity Review (submitted to Government in 2016) recommended significant investment in our ambulance services. In that context, the National Ambulance Service (NAS) is implementing a multi-annual programme involving manpower, vehicles and technology.
This year, in line with the Programme for Government commitment to continue to increase capacity in the National Ambulance Service, an unprecedented €187.5 million is being invested in these services. This includes €10m in development funding to facilitate the recruitment of 125 WTEs to progress priority areas in line with NAS strategic reform. Examples of strategic initiatives progressed in 2021 include:
- Continuing to target capacity deficits as identified in the NAS emergency service baseline and capacity review;
- Progressing the development of alternative patient care pathways;
- Strengthening the capacity of NAS critical care and retrieval services;
- Progressing the implementation of the Trauma System for Ireland.
2931. Deputy David Cullinane asked the Minister for Health if advice can be provided in relation to a matter raised in correspondence regarding vaccination (details supplied); and if he will make a statement on the matter. [39660/21]
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.
2932. Deputy Pa Daly asked the Minister for Health the timeline on the return of live music for weddings; and if the return of live music for weddings is tied to its return in wider hospitality settings. [39661/21]
View answer3031. Deputy Pauline Tully asked the Minister for Health if live music is currently permitted at a wedding reception; if not, when the Covid-19 guidelines for weddings are due to be reviewed; if it is likely that live music will be permitted at this stage; and if he will make a statement on the matter. [40063/21]
View answer3188. Deputy Niamh Smyth asked the Minister for Health when live music will resume at a wedding ceremony and reception to reflect the change due to vaccination and especially in the context of the size of the location in which the ceremony or reception is to take place with the reopening of hospitality pending; and if he will make a statement on the matter. [40616/21]
View answer3239. Deputy Róisín Shortall asked the Minister for Health if weddings are permitted to have novelty acts with a seated audience, for example, a magician under current Covid-19 guidelines; and if he will make a statement on the matter. [40970/21]
View answerI propose to take Questions Nos. 2932, 3031, 3188 and 3239 together.
As the Deputies will be aware, on 29 June, Government announced the next phase of reopening the economy and society in line with Recovery and Resilience: The Path Ahead.
While significant progress is being made in relation to the roll-out of our vaccination programme, the rapidly increasing prevalence of the more transmissible Delta variant, and the significant risk this poses, in particular to those who are not yet fully vaccinated, meant that a number of higher risk indoor activities did not recommence as planned on 5 July, pending the implementation of a system to verify vaccination or immunity status. However, as an exception, weddings already planned have been allowed to proceed with the planned increase in the number of guests to 50 at the wedding reception with protective measures from 5 July.
Unfortunately, the outlook for the coming weeks is very uncertain and there is not yet an indication of when live music, performances or dancing will be permitted at weddings. This is outlined further in the Fáilte Ireland guidelines. These guidelines can be found online: covid19.failteireland.ie/operational-guidelines/. The epidemiological situation will be monitored on an ongoing basis and the level of restrictions will be kept under review by Government.
Significant and sustained progress has been made on suppressing the virus over recent months due to the huge effort of people across the country. By working together, we have saved lives and limited the impact of the disease on society in Ireland. To protect the gains of recent months we must continue to practice basic preventative behaviours and to follow public health guidelines.
2934. Deputy David Cullinane asked the Minister for Health if he will outline by CHO or any smaller unit in which HSE dental services have been limited to emergency provision only for children and or adults for each month of 2020 and to date in 2021, as was done in Kildare/West Wicklow; if any other units are considering the confinement of services; the reason for each which has been confined; and if he will make a statement on the matter. [39663/21]
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.
2935. Deputy David Cullinane asked the Minister for Health when routine and elective treatments including school dental checks and dental appointments for children and adults will resume in Kildare/West Wicklow; if any of these services have been suspended in any other CHO; and if he will make a statement on the matter. [39664/21]
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.
2936. Deputy Violet-Anne Wynne asked the Minister for Health the position regarding the risk assessments considered by the board of management at the Rotunda Maternity Hospital relating to the premature induction of pregnant women as part of a clinical trial for dilipan-s; if his attention has been drawn to the fact that premature induction is contraindicated by many academic studies; if his attention has been further drawn to the fact that the ethics committee has not responded to formal queries of persons regarding their concerns regarding the said trial; if his attention has been drawn to this trial; and if he will make a statement on the matter. [39665/21]
View answerClinical trials in Ireland are governed by the European Communities (Clinical Trials on Medicinal Products for Human Use) Regulations, 2004 (S.I. No. 190 of 2004), and amendments. In accordance with these Regulations, a clinical trial may only be started or conducted in Ireland if:
- an ethics committee has issued a favourable opinion;
- the Health Products Regulatory Authority (HPRA) has granted an authorisation, and;
- the trial sponsor, or legal representative of the sponsor, is established within the European Economic Area.
The trial referred to by the Deputy was authorised by the HPRA for conduct in Ireland in July 2020, following a favourable scientific assessment of the benefit/risk of the trial. The trial was also authorised by an ethics committee recognised by the Department of Health under the relevant legislation.
The trial involves an assessment of the use of two authorised methods of induction of labour, a medical device (Dilapan-S) and a medicine (dinoprostone, Propess). The trial population are normal risk nulliparous women at 39 weeks’ gestation with no medical complications, and who have no contraindications to the induction of labour. Subjects are randomised to different treatment groups, and administered the relevant treatment in hospital before returning home for 12-24 hours after initiation of induction of labour.
Published literature indicates that the induction of labour may have a role in accomplishing lower Caesarean section rates, reduced neonatal morbidity and mortality rates, and improved maternal experience. There is evidence to suggest that induction of labour at 39 weeks gestation may have these benefits; the trial seeks to identify the best method of achieving induction of labour in the patient population being studied.
I have asked officials in my Department to request further details from the Rotunda Hospital regarding the trial in question, and will reply directly to the Deputy once this information is received.
2937. Deputy David Cullinane asked the Minister for Health if advice will be provided regarding a matter raised in correspondence (details supplied); and if he will make a statement on the matter. [39666/21]
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.
2938. Deputy Francis Noel Duffy asked the Minister for Health the reason for the period of natural immunity through contracting Covid-19 is considered six and not nine months as supported by the HSE for persons to request an EU Digital COVID Certificate; and if he will make a statement on the matter. [39667/21]
View answerUnder the EU Digital COVID Certificate Regulation a recovery certificate is valid not more than 180 days after the date of first positive NAAT test result. The advice in Ireland is that immunity persists for at least 9 months post recovery from infection or full vaccination. The shorter period for EU Digital COVID Certificate is a function of the approach taken by EU rather than public health advice in Ireland.
2939. Deputy David Cullinane asked the Minister for Health the number of consultants at Beaumont Hospital performing full removal of transobturator mesh implants; the number of surgeries performed in the past 12 months; the outcomes of these surgeries; and if he will make a statement on the matter. [39673/21]
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.
2940. Deputy David Cullinane asked the Minister for Health the number of HSE patients who have been facilitated for treatment in the US for full or partial removal of transobturator mesh implants; if a patient could access public funding for such treatment in the US; if so, the person or body that authorises this; and if he will make a statement on the matter. [39674/21]
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.
The HSE has indicated that as the procedure is available in Ireland it does not fall under the qualifying criteria for the Treatment Abroad Scheme. A multidisciplinary National Specialist Centre has been developed over 2 sites at Cork University Maternity Hospital (CUMH) and the National Maternity Hospital (NMH) Dublin and these have received specific funding from the HSE for the provision of these services. Full details of MESH removal services and contact information for relevant hospitals are available on the HSE website at www.hse.ie/eng/about/who/acute-hospitals-division/woman-infants/vaginal-mesh-implants/. Women affected by mesh continue to be strongly encouraged to engage with the relevant HSE contact points and the associated care pathways, to ensure that their service needs can be identified and provided for.
