Tuesday, 27 Jul 2021

Health Services Staff

Questions (2965)

David Cullinane

Question:

2965. Deputy David Cullinane asked the Minister for Health if orthoptics will be a regulated profession; and if he will make a statement on the matter. [39721/21]

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Written answers

CORU is Ireland's multi-profession health regulator responsible for regulating health and social care professionals designated under the Health and Social Care Professionals Act 2005. There are 17 health and social care professions designated for regulation under the 2005 Act, including orthoptists.

Currently there are registers open for 11 professions and CORU continues the complex work of preparing for regulation the other professions, which includes Orthoptists, that are designated for regulation under the Act.

Nursing Homes

Questions (2966)

David Cullinane

Question:

2966. Deputy David Cullinane asked the Minister for Health when the value for money review on nursing home care costs will be published. [39722/21]

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Written answers

Minister of State at the Department of Health

In March 2018, the Oireachtas Public Accounts Committee recommended that the Government undertake a Value for Money review to identify, quantify and analyse the reasons for any cost differential between private/voluntary and public nursing homes, and following analysis, to make recommendations for improving the value for money obtained by the Health sector.

The review was undertaken under the direction of a Steering Committee led by an independent chairman and comprising representatives of the Department of Health (DoH), the Department of Public Expenditure and Reform (DPER), the National Treatment Purchase Fund (NTPF), the Health Service Executive (HSE), and the Economic and Social Research Institute (ESRI).

The Review has taken longer to complete than originally anticipated. Initially, delays were encountered while attempting to obtain sufficient private sector data to allow for a meaningful comparison between the sectors. As work was progressing to resolve this issue, the COVID-19 pandemic struck. As a result, the review was temporarily paused in order to focus all resources in responding to the crisis.

The Review has now been completed and has been signed off by the Steering Committee. In line with the requirements of the Public Spending Code, a Memo for Government is due to issue shortly.

Healthcare Policy

Questions (2967)

David Cullinane

Question:

2967. Deputy David Cullinane asked the Minister for Health if and when the palliative care evidence brief will be published. [39723/21]

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Written answers

Minister for Health

The Programme for Government commits to updating the Palliative Care policy for adults to reflect the main developments in end-of-life care and international best practice since 2001 and with a view to addressing the interface with children's palliative care. It is envisaged that the new policy will take account of increased demand for adult palliative care, the shift towards care in the community and the emphasis in Sláintecare on addressing geographic variations in the provision of both community and hospital palliative care services.

In order to inform deliberations in relation to the update, my Department has commissioned an evidence brief, produced by the Health Research Board, which describes national adult palliative care policies across four countries: Australia, New Zealand, Scotland and the Netherlands. The Health Research Board do not publish evidence briefs, only evidence reviews, as evidence briefs are working documents and therefore cannot be peer reviewed which is required for publication.

My Department also intends to commission a review of the implementation of the 2001 policy as it relates to adult palliative care in order to identify priority areas that should be addressed in the policy update, including areas of evolving and emerging need, having regard to international developments. My Department is currently in the process of evaluating tender applications for this work.

It is envisaged that a public consultation will be undertaken by my Department prior to commencing work on drafting the policy update.

Health Services Staff

Questions (2968)

David Cullinane

Question:

2968. Deputy David Cullinane asked the Minister for Health if and when the literature review of international approaches to the regulation of health and social care professions will be published. [39724/21]

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Written answers

Minister for Health

My department instructed the Health Research Board to carry out research on its behalf concerning international approaches to regulating health and social care professions. I can confirm that this report was received by the Department in June of this year and is currently being examined by my officials following which a decision on publication will be made.

Medicinal Products

Questions (2969)

David Cullinane

Question:

2969. Deputy David Cullinane asked the Minister for Health if and when the review of the governance arrangements and the resources currently in place to support the Health Service Executive reimbursement and pricing decision making process (details supplied) will be published. [39725/21]

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Written answers

Minister for Health

Following a tender by the Office of Government Procurement, Mazars conducted a review of the governance structures around the HSE's drug reimbursement process. The report was submitted to my Department in January 2020.

The review made recommendations in respect of the HSE’s systems, structures, processes, governance arrangements and use of specialist resources in respect of the drug reimbursement process.

The report was under consideration by officials earlier last year, however the focus of the Department of Health changed to the immediate public health considerations of the COVID-19 pandemic and the preservation of life. This meant that this work stream was temporarily suspended to reallocate resources to support essential services.

My Department aims to complete its consideration of the report’s recommendations in the near future.

Departmental Reviews

Questions (2970)

David Cullinane

Question:

2970. Deputy David Cullinane asked the Minister for Health the status of the review by the expert review body on nursing and midwifery; and if the review will be published. [39726/21]

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Written answers

Minister for Health

The Expert Review Body for Nursing and Midwifery is continuing its work, as set out in its Terms of Reference. It has completed a stakeholder engagement and is currently in the process of drafting its report which will be presented to me in due course.

Tax Code

Questions (2971)

David Cullinane

Question:

2971. Deputy David Cullinane asked the Minister for Health the status of the sugar sweetened drinks tax evaluation; and if the evaluation will be published. [39727/21]

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Written answers

Minister of State at the Department of Health

The Sugar-Sweetened Drinks Tax was introduced on 1st May 2018, and has now been in operation for more than three years. The introduction of the tax was an important action in the Obesity Policy and Action Plan, with the aim of combatting obesity through reducing consumption of added sugar in drinks and encouraging reformulation of products by the drinks industry.

Initial indications are that the tax has had a positive impact, particularly in terms of encouraging drinks producers to reduce the sugar content in their products. However, a more comprehensive analysis of the effects of the tax is needed, and the Department has thus commenced an evaluation of the measure.

The first step in this process was to look at existing examples that could inform the methodology to assess the impacts of the tax. This work is well advanced. Allied to this, information has been gathered on existing datasets that could be analysed as part of the assessment of the impact of the tax. The literature review and data scoping exercise will enable the Department to make an assessment of the potential approaches to evaluate the impact of the tax and the timelines and resources required for the evaluation. It is intended that the evaluation will be published when completed.

Healthcare Policy

Questions (2972)

David Cullinane

Question:

2972. Deputy David Cullinane asked the Minister for Health the status of the research programme in healthcare reform; and if a review will be published. [39728/21]

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Written answers

Minister for Health

The Research Programme in Healthcare Reform is a programme agreed between the Department of Health and the ESRI which commenced in July 2014. The broad objectives of the programme are to apply economic analysis to explore issues in relation to health services, health spending and population health, in order to inform the development of health policy and the Government’s healthcare reform agenda. Since its commencement, the programme has produced 31 publications. Full details can be found here:

www.esri.ie/current-research/research-programme-in-healthcare-reform

www.esri.ie/research/health-and-quality-of-life/hippocrates-model

The first major publication of the research programme involved an examination of the cost implications of a change to a multi-payer, Universal Health Insurance model, as proposed in the 2014 White Paper on Universal Health Insurance (UHI), ‘The Path to Universal Healthcare’. This research was published in November 2015 as ESRI Research Series Report 45 ‘An Examination of the Potential Costs of Universal Health Insurance in Ireland’.

The next major phase of the programme was the development in the years from 2015 to 2017 of the demand phase of the Hippocrates projection model for healthcare demand and expenditure. Projections of demand from 2015 to 2030 were published in October 2017 as ESRI Research Series Report 67 ‘Projections of demand for healthcare in Ireland, 2015-2030: First report from the Hippocrates Model’. This report was based on new ESRI projections for population growth, the first to be published based on the 2016 Census. The report contained the most comprehensive mapping of public and private activity in the Irish healthcare system to have been published.

In December 2020, the ESRI published ‘Projections of expenditure for public hospitals in Ireland, 2018–2035, based on the Hippocrates Model’ which provides projections of expenditure for public acute hospital and adult acute psychiatric in-patient services in Ireland for the years 2018–2035 based on new ESRI projections for population and economic growth, both of which consider the impact of COVID-19. A range of alternative projections are presented reflecting alternative assumptions about population growth, trends in health and life expectancy, policy change, and costs. This report provided the most comprehensive mapping of Irish public hospital expenditure to have been published to date. This report was launched alongside the reports: The Survey and Statistical report ‘Utilisation of public acute hospital services in Ireland — baseline analysis for the Hippocrates model’ and the Working Paper ‘Paying more to wait less: Estimating the cost of reducing Ireland’s public hospital waiting lists’.

At present, the ESRI is finalising the report ‘Projections of Expenditure for Primary, Community and Long-Term Care Ireland 2019–2035, Based on the Hippocrates Model’, due for publication shortly. This will provide the most comprehensive mapping of expenditure in these areas to be published in Ireland to date.

My Department’s participation in this research programme is continuously monitored and reviewed to ensure the programme is delivering on its stated objectives and achieving value for money.

I hope this clarifies the matter for the Deputy.

Departmental Reviews

Questions (2973)

David Cullinane

Question:

2973. Deputy David Cullinane asked the Minister for Health the status of the safe nurse staffing and skill mix review; and if he will make a statement on the matter. [39729/21]

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Written answers

Minister for Health

The Safe Staffing Framework is an evidence-based methodology to determining the nursing workforce required based on patient acuity and dependency. The Framework was launched by Minister Harris, on 16 April 2018, on publication of the Final Report and Recommendations of the Taskforce on Staffing and Skill Mix for Nursing, on a Framework for Safe Nurse Staffing and Skill Mix in General and Specialist Medical and Surgical Care Settings in Adult Hospitals www.gov.ie/en/publication/2d1198-framework-for-safe-nurse-staffing-and-skill-mix-in-general-and-speci/. To date there have been three phases of the Safe Staffing Framework Development:

Phase 1 - Framework for Safe Nurse Staffing and Skill Mix in General and Specialist Medical and Surgical Care Settings in Adult Hospitals.

Phase 2 - Framework for Safe Nurse Staffing and Skill Mix in Emergency Care Settings.

Phase 3 - Framework for Safe Nurse Staffing in Community settings, including (a) Long-Term residential care settings for older persons, (b) Community care settings, and (c) Step-down and Rehabilitation settings.

Phase 1 of The Framework was handed over to the HSE in October 2019 for national roll-out. This phase of the Framework considered the skill mix levels across general and specialist medical and surgical patient care settings in acute hospitals. Phase 1 was implemented and tested through a pilot project across three hospital sites; Beaumont Hospital, Our Lady of Lourdes Hospital, Drogheda and St Columcille's, Loughlinstown.

The impact reports, using the data collected over two years with the support of a specific ICT system, have validated the initial findings from the pilot test. There is evidence of sustained improvements to patient outcomes, service and financial efficiencies and a number of positive workforce outcomes, including increased retention in areas where the Framework has been fully implemented. Implementation is being progressed by the HSE with €10m assigned in Budget 2021 to fund the associated staffing costs.

Phase 2 focuses on the nursing workforce requirements of emergency care settings (A&E). This stage of the Framework has been piloted in four Emergency Care Settings since Q4 2019. Due to the impact of the pandemic, the pilot was extended to examine the impact of COVID-19 on nursing workforce requirements in these care settings. The final impact report is due to be examined by the Taskforce in the coming weeks and, following endorsement, it will be presented to me. Phase 2 has led to the employment of an additional 77 whole time equivalent nursing staff in emergency care settings.

Phase 3 of the Framework relates to community care settings and due to its scale is sub-divided into three distinct stages. The first stage focuses on the long-term residential care setting for older persons and is a recommendation of the COVID-19 Nursing Homes Expert Panel (NHEP). The Framework will determine, through an evidence-based approach, appropriate nurse staffing levels and skill mix to meet residents' needs first; and will focus on delivering positive resident outcomes. A Safe Staffing Taskforce for Phase 3 has been established and it will work collaboratively with key stakeholders to meet the NHEP recommendations. Phase 3 will consider care in both public and private settings in urban and rural locations. Pilot site selection is currently underway with testing due to commence in Quarter 4 of 2021.

Vaccination Programme

Questions (2974)

David Cullinane

Question:

2974. Deputy David Cullinane asked the Minister for Health if he has considered engaging with NIAC to examine the possibility of giving a booster shot of Covid-19 vaccine to vulnerable groups in the high risk and very high risk categories, for example, organ recipients; and if he will make a statement on the matter. [39745/21]

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Written answers

Minister for Health

The National Immunisation Advisory Committee (NIAC) is currently reviewing future vaccination requirements, including the potential need for booster shots and is expected to make recommendations in this regard shortly. Following receipt of the NIAC advice, my Department and the HSE will consider the appropriate operational measures to implement the recommendations.

Health Services

Questions (2975)

David Cullinane

Question:

2975. Deputy David Cullinane asked the Minister for Health if advice will be provided on a matter raised in correspondence (details supplied) in relation to the treatment abroad scheme; and if he will make a statement on the matter. [39762/21]

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Written answers

Minister for Health

Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.

As this Parliamentary Question relates to an operational issue, it is a matter for the HSE. However, given the recent cyber-attack, which has required a temporary shut-down of HSE IT systems, my Department contacted the HSE regarding the current status of the patient’s application under the Treatment Abroad Scheme (TAS). The disruption to service is on-going, however the HSE have confirmed that the latest information they have available is that the patient's application was incomplete and an extension was granted until 6th August 2021 to allow for the submission of required documentation.

Further queries with regard to this application should be directed to the HSE TAS office. The TAS office may be contacted by phone on 056 778 4900 / 056 778 4908; by email at treatmentabroad.scheme@hse.ie or in writing at Health Service Executive, Seville Lodge, Callan Road, Kilkenny, Co Kilkenny. Further information is also available on the TAS website.

Health Services

Questions (2976, 2977)

Thomas Gould

Question:

2976. Deputy Thomas Gould asked the Minister for Health if he plans to take action on the exclusion of addiction treatment facilities from the HIQA remit. [39764/21]

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Thomas Gould

Question:

2977. Deputy Thomas Gould asked the Minister for Health if he plans to take action on the lack of public oversight and transparency in addiction treatment facilities. [39765/21]

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Written answers

Minister of State at the Department of Health

I propose to take Questions Nos. 2976 and 2977 together.

Under the Health Act 2004, as amended, the HSE is responsible for the provision of health and personal social services including addiction services. The HSE either provides these services directly or contracts to have them provided on its behalf.

Organisations providing addiction treatment services, funded by the HSE, are required to meet minimum standards in the delivery of services across a range of criteria as part of the service level agreement process.

The Department of Health has no jurisdiction over agencies that provide private addiction treatment services.

There is no provision in legislation for the introduction of regulations relating to the inspection of residential addiction treatment centres by HIQA.

I am committed to ensuring there is transparent monitoring and oversight of publicly funded drug and alcohol treatment services.

Question No. 2977 answered with Question No. 2976.

Hospital Staff

Questions (2978)

Mairéad Farrell

Question:

2978. Deputy Mairéad Farrell asked the Minister for Health the position regarding the recruitment of the main lead paediatric pain consultant roles in Children’s Health Ireland; and if he will make a statement on the matter. [39768/21]

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Written answers

Minister for Health

In 2020, funding was provided to CHI to develop services to address the needs of children, adolescents and their families living with complex pain in Ireland. This funding provides for an interdisciplinary service, consisting of consultant with special interest in pain management (1 WTE), administration (1.2 WTE), clinical nurse specialist (1.0 WTE), advanced nurse practitioner (1.2WTE), occupational therapist (1.0 WTE), physiotherapist (1.0 WTE) and psychologist (1.0 WTE).

CHI has advised that all posts are in place except for the consultant position. Recruitment for this post has so far been unsuccessful, and is still ongoing. Having been previously advertised, the post has now been redesigned which it is hoped will assist in attracting suitable candidates. CHI has also advised that a locum consultant (0.5 WTE) is employed on an interim basis until such time as the permanent consultant position is filled.

Question No. 2979 answered with Question No. 2879.

Covid-19 Tests

Questions (2980)

Louise O'Reilly

Question:

2980. Deputy Louise O'Reilly asked the Minister for Health if the HSE guidelines in relation to close contacts and testing will be updated due to the Covid-19 delta variant; if it is due to remain the same; and if he will make a statement on the matter. [39771/21]

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Written answers

Minister for Health

Testing and contact tracing continues to be a key component of the response to the pandemic. In line with evolving public health policy advice, the HSE has put in place a comprehensive, reliable and responsive testing and tracing operation. The testing and tracing service is kept under constant review to respond to changing circumstances, including those caused by the Delta variant.

The HSE currently has swabbing capacity of 175,000 tests per week across community, acute serial and outbreak programmes. Demand for testing and tracing is currently high but every community test centre around the country currently accepts walk-ins. Alternatively, a test can be booked on the new online booking portal for any nearby test centre.

Contact Tracing Centres operate 12 hours a day, 7 days a week and are fully rostered every day. The dedicated workforce, now totalling 930 Contact Tracers, has been key to ensuring adequate capacity for contact tracing up to 1,600 detected cases per day. This involves full data gathering and phone calls to all cases and their contacts. The service can now deploy digital mechanisms to significantly increase capacity and continue to contact trace through surge periods if the daily rate goes above 1,600 cases a day.

In response to the ongoing effort to contain the spread of the virus, the HSE has indicated that it is aiming to increase capacity to around 30,000 swabs per day in community and acute settings. This will be done through extending hours at swabbing centres, expanding the number of open sites, and increasing the level of capacity within each of them, including through a targeted use of the support provided by the National Ambulance Service. The HSE has indicated its intention to use lateral flow antigen tests for self-testing by close contacts should challenges in the demand for PCR testing capacity arise. Furthermore, close contacts who have been fully vaccinated are no longer referred automatically for testing but the contact tracing team advises the person depending on circumstances.

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.