Dáil Éireann Debate, Thursday - 9 September 2021
1125. Deputy David Cullinane asked the Minister for Health the status of the work undertaken to reopen the GMHS; the progress made to date regarding the recruitment of permanent staff at St James's Hospital, Meath primary care centre, St. Vincent's Private Hospital and the Mater Misericordiae University Hospital in order to resume new applications; and if he will make a statement on the matter. [41811/21]
View answerThe Gay Men's Health Service (GMHS) reopened in January 2021, on a phased basis and in line with Government and HSE guidelines. With gradual increases in staffing and other additional resources, the GMHS has been able to incrementally expand the number of services offered during the course of 2021.
The GMHS PrEP service has recommenced and is seeing both new and returning service users. The Clinic’s Consultant in Infectious Diseases (GMHS and GUIDE Clinic, St James’s Hospital) and other doctors are providing virtual consultations, and PrEP service users attend GMHS for STI screening, blood testing and treatment as required.
Those with diagnosed STIs or requiring Hepatitis and/or HPV vaccine continue to be treated in GMHS also. A weekly STI clinic has commenced for symptomatic screening and treatment of both new and returning service users and, also, follow up for those who require further treatment or vaccinations. The GMHS Nurse led asymptomatic screening service has also been re-instated, following the recent HSE cyber-attack.
The closure of the GMHS in 2020 resulted from the pressures arising from the Covid-19 pandemic and related primarily to the necessary redeployment of increasing numbers of personnel to diverse COVID-19 related duties. Staff in the Gay Men’s Health Service (GMHS) were reassigned, by reason of necessity, to other HSE services. Following the GMHS closure, significant efforts were made to maintain service provision through other locations, including the GUIDE Clinic in St. James’ Hospital.
Prior to the pandemic, the GMHS was staffed by 97% agency staff; this is no longer the case. Funding for the PrEP programme allowed pro-rata recurring funding to be allocated to GMHS in 2020. As a result of pandemic related pressures on staffing, recruitment in 2020 initially focused on the services required to support the Covid-19 pandemic.
However, the HSE advises that a recruitment campaign to fill the posts for the GMHS PrEP programme commenced in the latter part of 2020 and is progressing well. 6 permanent posts in GMHS have been filled, with 3 still in recruitment phase. Furthermore, interviews for a permanent consultant position are expected to take place in September. IT improvements have also been put in place.
HSE Community Healthcare East advises that they have made every effort to restore, and maintain services as far as is possible, given current pandemic related pressures on resources.
All health services, including the GMHS, are continuing to face constraints, resulting from the impacts of the Covid-19 pandemic. It should be noted that, in order to ensure compliance with HSE Covid-19 safety measures, capacity at clinics is somewhat reduced.. Constraints include attendance by appointment only, or online as a result of the need to maintain social distancing.
The GMHS will continue to reinstate services on a phased basis and in line with the HSE's Safe Return to Work Guide. Officials from the Department of Health and HSE Sexual Health and Crisis Pregnancy Programme are in regular contact with CHO6 in order to monitor progress. It is hoped that it will be possible to increase capacity as recruitment progresses, vaccination rates increase, and Covid-19 restrictions can safely be scaled back, in line with official guidelines.
The GMHS website is updated regularly, and provides full details of services available, as these are reinstated. It is hoped that GMHS services can be delivered to their full potential and developed further, once pandemic related constraints on health service capacity as a whole can be safely reduced.
HIV Pre-Exposure Prophylaxis (PrEP) is available, free of charge through the HSE, to those at substantial risk of acquiring HIV through sexual activity. PrEP is delivered through approved services that meet the National Standards for PrEP Service Delivery (www.sexualwellbeing.ie/prepproviders ) and is being rolled out in a phased manner. There are currently thirteen public and nine private approved PrEP service providers in Ireland www.sexualwellbeing.ie/getprep.
Funding of €5.4 million was secured for PrEP in 2020, including allocations for the recruitment of additional staff. Funding and roll-out of the programme continues in 2021.
Whilst the PrEP programme remains fully funded, implementation has been impacted as a result of the Covid-19 pandemic. All health services, including STI/HIV/PrEP services, are continuing to face constraints, resulting from the impacts of the Covid-19 pandemic. These include attendance by appointment only, or online as a result of the need to maintain social distancing.
With regard to PrEP provision in Dublin, the HSE advise that two of the four Dublin based services have indicated that they currently need to limit new PrEP appointments. However, the other two services anticipate some additional capacity in the coming months. Of note, two large Dublin based services have reported an increase in the number of patients not attending their appointments, which has generated some extra capacity but an additional associated workload in determining the needs and wishes of those who have not attended for appointment.
The HSE has provided the following recruitment update with respect to PrEP:
Gay Men's Health Service: 6 permanent positions have been filled, 3 are still in recruitment phase, and a permanent consultant position is also in recruitment phase
GUIDE Clinic, St James' Hospital: All agreed PrEP posts have been recruited on a permanent basis (8 individuals with an aggregate whole time equivalent (WTE) of 4.32)
St Vincent's University Hospital: All agreed PrEP posts have been recruited on a permanent basis (4 individuals with a WTE of 3.0)
Mater Misericordiae University Hospital: All agreed PrEP posts have been recruited on a permanent basis (5 individuals with a WTE of 4.25), with the exception of part of the 0.5 WTE consultant post (a permanent 0.2 WTE is in place, the additional 0.3 WTE is under recruitment).
