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Wednesday, 15 Sep 2021

Written Answers Nos. 583-603

General Practitioner Services

Questions (584)

Dara Calleary

Question:

584. Deputy Dara Calleary asked the Minister for Health if his attention has been drawn to the fact that medical card holders are routinely being charged for blood tests in many general practitioner practices; if medical card holders should be charged for blood tests; and if he will make a statement on the matter. [43212/21]

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Written answers

There is no provision under the GMS GP contract for persons who hold a medical card or GP visit card to be charged for routine phlebotomy services provided by their GP which are required to either assist in the diagnosis of illness or the treatment of a condition. This has been advised to GPs by the HSE. Notwithstanding this, I am aware that some GPs are charging GMS patients for phlebotomy services in some circumstances.

The issue of GPs charging GMS patients for phlebotomy services is complex given the numerous reasons and circumstances under which blood tests are taken. My Department and the HSE discussed this issue previously with the relevant GP representative body. However, it did not prove possible to achieve agreement that no charges for blood tests would be applied in any circumstances. It is intended to raise this issue again at an appropriate time.

It should be noted that the GP chronic disease management programme which is being phased in, having commenced last year, will involve the ongoing monitoring of patients’ conditions and any blood tests required in this context will be covered by the fees payable for this care.

The position remains that where a patient who holds a medical card or GP visit card believes he or she has been incorrectly charged for routine phlebotomy services by his or her GP, then that patient should report the matter to their HSE Local Health Office. The local management, upon being notified of potential inappropriate charging of GMS patients, carry out an investigation into each complaint and will, where appropriate, arrange for a refund of charges incorrectly applied by the GP.

Dental Services

Questions (585)

Jennifer Murnane O'Connor

Question:

585. Deputy Jennifer Murnane O'Connor asked the Minister for Health if his attention has been drawn to the fact that orthodontic treatment for children in County Carlow in the public system is only being carried out on an emergency basis in view of the fact private patients are able to access orthodontic treatment easily; the reason a child (details supplied) in County Carlow was referred five years ago for orthodontic treatment via the HSE school dentist and is still awaiting an appointment; and if he will make a statement on the matter. [43223/21]

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Written answers

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Hospital Procedures

Questions (586)

Michael Healy-Rae

Question:

586. Deputy Michael Healy-Rae asked the Minister for Health when the results of a scan will issue to a person (details supplied); and if he will make a statement on the matter. [43230/21]

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Written answers

As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.

Covid-19 Pandemic

Questions (587)

Michael McNamara

Question:

587. Deputy Michael McNamara asked the Minister for Health when certificates and passports for vaccinations administered will issue to persons who recently have moved here from outside the EU; and if he will make a statement on the matter. [43231/21]

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Written answers

The EU Digital COVID Certificate is proof that a person has undergone a medical event in Ireland including a COVID-19 vaccination, COVID-19 test, or recovery from COVID-19. Individuals can expect their vaccination certificate to be issued automatically following the completion of their final vaccination dose. Information on accessing an EU Digital COVID Certificate for tests and recovery is available on gov.ie

Following the successful rollout of the initial implementation phase of the EU Digital COVID Certificate in Ireland, the Government is creating a specific portal to enable Irish citizens vaccinated outside of the EU, with vaccines authorised for use in Ireland, to obtain a COVID certificate valid in Ireland and across the EU.

This portal is currently being advanced on a cross departmental basis involving technical and process development, and resource management. It is expected that an announcement on the launch of this portal will be made shortly.

Departmental Expenditure

Questions (588)

Carol Nolan

Question:

588. Deputy Carol Nolan asked the Minister for Health if his Department has utilised the services of organisations (details supplied) at any time from 1 January 2015 to date; if so, the expenditure costs related to same; the purpose of any such engagements; and if he will make a statement on the matter. [43241/21]

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Written answers

Since 1st January 2015, the Department of Health have not utilised the services of either Common Purpose Ireland or Common Purpose UK.

Care Services

Questions (589)

Dara Calleary

Question:

589. Deputy Dara Calleary asked the Minister for Health his plans for establishing a commission on care as per the commitment in the Programme for Government; the process and timeline involved; and if he will make a statement on the matter. [43265/21]

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Written answers

In June 2020, the Programme for Government, mindful of the particular impact of COVID-19 on older people, especially those who live on their own and people living in nursing homes, set out a commitment to establish a commission to examine care for older people.    

While preliminary scoping work on the establishment of a commission on care has commenced in the Department of Health, the ongoing priority focus in 2021 is ensuring the continued implementation of the recommendations of the COVID-19 Nursing Homes Expert Panel. Many of the short and medium term recommendations have already been implemented.    

Care Services

Questions (590)

Dara Calleary

Question:

590. Deputy Dara Calleary asked the Minister for Health the implementation plan for funding the carer’s guarantee funding before the end of 2021; and if he will make a statement on the matter. [43266/21]

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Written answers

The Programme for Government commits to delivering a ‘Carers Guarantee’ proposal that will provide a core basket of services to carers across the country, regardless of where they live. This commitment is consistent with the National Carers' Strategy, which seeks to support family carers to care with confidence through the provision of adequate information, training, services and supports. In line with this commitment, and as a first step towards implementing the Carers’ Guarantee, €2 million has been allocated in Budget 2021 to provide a more standard package of supports to family carers in every region, in tandem with the community and voluntary sector. Discussions are underway between my Department and the HSE to determine how this funding will be allocated and to ensure measures introduced will work towards addressing geographical inequity of access to supports.

Home Help Service

Questions (591)

Dara Calleary

Question:

591. Deputy Dara Calleary asked the Minister for Health if his attention has been drawn to challenges in recruiting persons to fill home help hours as in persons to work these hours for persons allocated hours; and if he will engage with colleagues across Government in order to address this challenge. [43267/21]

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Written answers

The Department of Health is cognisant of the challenges associated with recruiting and retaining staff in the home help sector and is committed to working across Government and with relevant stakeholders to ameliorate these issues. The Programme for Government committed to establishing a Workforce Planning Expert Unit to work with the education sectors, regulators, and professional bodies to improve the availability of health professionals and reform their training to support integrated care across the entire health service.

A Strategic Workforce Planning (SWFP) Unit has been established within the Department of Health to achieve these aims. They key objective of the Unit is the development of an Integrated Health Workforce Planning Strategy and Workforce Planning Model in consultation with key stakeholders and in line with the Programme for Government commitment to define health workforce planning needs across the entire health sector, including both public and private health care provision, into the future.

Medical Aids and Appliances

Questions (592)

Aodhán Ó Ríordáin

Question:

592. Deputy Aodhán Ó Ríordáin asked the Minister for Health if the HSE will provide support for braces for patients with pectus carinatum such as a person (details supplied) in particular in circumstances in which there is evidence of associated conditions. [43269/21]

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Written answers

As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.

Birth Certificates

Questions (593)

Bernard Durkan

Question:

593. Deputy Bernard J. Durkan asked the Minister for Health when a birth certificate will issue in the case of a person (details supplied); and if he will make a statement on the matter. [43272/21]

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Written answers

Issues that caused delays to the registration of births as a result of systems not being available because of the cyber attack on the HSE in May, have since been resolved. Any delays in recent weeks are likely to be due to operational issues at individual registration offices.

Covid-19 Tests

Questions (594)

Réada Cronin

Question:

594. Deputy Réada Cronin asked the Minister for Health if schoolchildren tested in walk-in centres as opposed to school contact tracing, in which some parents are reporting in excess of 72 hour wait times and wish to proceed with testing on their own, will if they are positive be deemed community transmission or school transmission; and if they are deemed positive due to community transmission, if he will amend the classification in the interest of clarity regarding school transmission and virus presence; and if he will make a statement on the matter. [43280/21]

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Written answers

As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.

Proposed Legislation

Questions (595)

John Paul Phelan

Question:

595. Deputy John Paul Phelan asked the Minister for Health the current timeframe for the passage of the Human Tissue (Transplantation, Post-Mortem, Anatomical Examination, and Public Display) Bill through the Houses of Oireachtas; and if he will make a statement on the matter. [43282/21]

View answer

Written answers

The Programme for Government includes a commitment to "Enact the Human Tissue Bill".

The drafting of the Human Tissue (Transplantation, Post-Mortem, Anatomical Examination and Public Display) Bill is a priority for the Government.

My Department is progressing work on the drafting of the Bill in collaboration with the Office of Parliamentary Council with a view to ensuring that Government approval is secured to publish the Bill before the end of 2021. It is hoped that the Bill will then be progressed through the Houses of the Oireachtas.

Hospital Staff

Questions (596)

David Cullinane

Question:

596. Deputy David Cullinane asked the Minister for Health the number of vacant consultant posts including posts filled on a temporary basis or by locum staff by hospital and by hospital group in tabular form; and if he will make a statement on the matter. [43289/21]

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Written answers

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Hospital Services

Questions (597)

David Cullinane

Question:

597. Deputy David Cullinane asked the Minister for Health the estimated cost to fully remove private healthcare from public hospitals; and if he will make a statement on the matter. [43290/21]

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Written answers

Estimates of costs on the expansion of public activity in public hospitals were set out in the 2017 Sláintecare Report. Independently-chaired talks are ongoing between officials from my Department, the HSE, and hospital consultants' representative bodies (the IMO and IHCA) on the proposed public-only contract. With these important talks ongoing, it would inappropriate for me to publicly pre-empt any potential outcome or potential associated costs.

General Practitioner Services

Questions (598)

David Cullinane

Question:

598. Deputy David Cullinane asked the Minister for Health the estimated cost of delivering free general practitioner care to all children up to the age of 18 years; and if he will make a statement on the matter. [43291/21]

View answer

Written answers

The Government is committed to increasing access to GP care without charges for children. The Health (General Practitioner Service and Alteration of Criteria for Eligibility) Act 2020 provides, amongst other things, for the phased expansion of GP care without fees to all children aged 12 years and under. The initial stage of this phased expansion will be the provision of GP care without fees to all children aged between 6 and 8. The appropriate date for commencing the expansion remains under consideration in light of COVID-19 and the additional pressures the expansion might place on general practice in that context.

It is not possible to give an estimate of the cost of extending GP care without fees to a further cohort of the population. The fees payable to GPs for that service could be determined only following consultation on the scope of the service to be provided and the rate of fees payable to GPs for the provision of that service.

Medical Research and Training

Questions (599, 610)

Neasa Hourigan

Question:

599. Deputy Neasa Hourigan asked the Minister for Health when pre-registration examination system level 3 medical exams will recommence; and if he will make a statement on the matter. [43292/21]

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David Cullinane

Question:

610. Deputy David Cullinane asked the Minister for Health if he has engaged with the Medical Council to ensure that PRES 3 candidates will be given an opportunity to sit their exams as soon as possible; his plans to allow PRES 3 candidates to obtain temporary registration; and if he will make a statement on the matter. [43332/21]

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Written answers

I propose to take Questions Nos. 599 and 610 together.

Doctors who have qualified in another jurisdiction and whose qualifications do not entitle them to automatic recognition are required to pass or be exempt from the Medical Council’s pre-registration exam, the PRES, which has two components -the PRES 2 which is a computer based exam and the PRES 3 which is primarily a test of clinical skills in the main clinical disciplines of Obstetrics & Gynaecology, Paediatrics, Psychiatry, Surgery, and Medicine/General Practice. The exam is in two parts, a written exam and an objective structured clinical examination to access the doctor's communication, interpretation and practical skills. These exams form an important part of the validation of qualifications and experience carried out by the Medical Council. They ensure that doctors applying for registration meet the required standards for registration in Ireland and are an important means of protecting patients.

The PRES 3 exams are hosted by the medical schools on behalf of the Medical Council. Due to the pandemic, the PRES 3 exams scheduled to take place in March 2020 were postponed and it has not been possible to reschedule the exams since. The Medical Council has had discussions with the medical schools to explore the possibility of running the PRES 3 exams but due to the pandemic and resulting public health restrictions, the medical schools did not feel they could safely host the exams for the Council. The Council is in regular contact with the Medical Schools and the matter is being followed up as a matter of urgency so as to be able to offer the PRES at the earliest opportunity. It is envisaged that a date for the exams will be confirmed in the very near future.

Health Services Staff

Questions (600)

Willie O'Dea

Question:

600. Deputy Willie O'Dea asked the Minister for Health if his attention has been drawn to the fact that there is no dietician provided for rheumatology patients in Ireland; his plans to address this situation; and if he will make a statement on the matter. [43298/21]

View answer

Written answers

As the issues raised by the Deputy relate to operational matters, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Covid-19 Pandemic

Questions (601)

Richard Boyd Barrett

Question:

601. Deputy Richard Boyd Barrett asked the Minister for Health the reason level 2 contact tracers are not paid the same as level 1 staff; if the quota will be removed for phone calls per day with the understanding that some calls are difficult and take longer than others in order to remove the pressure that staff face doing this important job; and if he will make a statement on the matter. [43301/21]

View answer

Written answers

As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.

Covid-19 Pandemic

Questions (602)

Richard Boyd Barrett

Question:

602. Deputy Richard Boyd Barrett asked the Minister for Health the provision there is in legislation for persons who cannot get vaccinated for medical reasons in relation to the vaccine passport system; and if he will make a statement on the matter. [43305/21]

View answer

Written answers

The EU Digital COVID Certificate concerns the issuing and verification of certificates for medical events including vaccination, recovery, and testing related to COVID-19. The EU Digital COVID Certificate regulation, and subsequent associated national regulations, do not provide for the issuing of a certificate for individuals who have not had a medical event as outlined. It should be noted that the percentage of people who cannot receive a COVID-19 vaccine for medical reasons is very small.

The indoor dining regulations (SI 385/2021 as amended) provide for the use of the EU DCC (amongst other proofs ) to access indoor hospitality.  There is currently no provision for persons who cannot provide proof of vaccination or recovery ( apart from a minor accompanied by a parent / guardian or a person who is on site in a professional capacity) to access indoor hospitality premises.

In terms of travel, it is important to note that the EU Digital COVID Certificate (DCC) is not a requirement but rather a record of a medical event which can make international freedom of movement easier.  Regulations regarding travel to the State have been developed on the basis of public health advice in order to limit to the greatest extent possible and reasonable the importation of Covid-19.  In general, where a traveller is unable to provide evidence of vaccination for any reason, a negative ('not-detected') PCR test result from a test taken no more than 72 hours before arrival permits the traveller entry to the State.

When a traveller has been in a designated state in the 14 days prior to arrival, there is an obligation to enter mandatory hotel quarantine unless the traveller is exempt.  The current set of exemptions is set out in SI 134 of 2021.  Travellers who have been vaccinated with an EMA-approved vaccine are currently exempted from the requirement to undergo mandatory hotel quarantine.  The states currently designated for the purposes of mandatory hotel quarantine are: Argentina, Bolivia, Brazil, Chile, Colombia, and Peru.  The list of designated states is kept under constant review, and changes are announced publicly and published on www.gov.ie/quarantine.

Finally, it should be noted that provision has been made for people who did not take up the offer of a second dose of AstraZeneca vaccine to be offered an mRNA vaccine in order to complete their vaccination schedule and a DCC is issued in such cases.  In this regard, the HSE has been advised to operationalise updated NIAC guidance in relation to the mixing of vaccines, specifically relating to certain people who are yet to complete a two-dose Covid-19 vaccine regimen.

The NIAC advice on heterologous vaccination relates to:

- those who are contraindicated from taking a second vaccine dose of a viral vector vaccine (e.g. had a severe reaction to the first dose of Vaxzevira® (AstraZeneca)) should be offered a second dose of an mRNA vaccine.

- those who have already had the first dose of Vaxzevria® and who did not complete the vaccination schedule as recommended should be offered an mRNA second dose in line with their priority grouping or age cohort.

The person would then be considered fully vaccinated after their second dose of an mRNA vaccine (7 days after Comirnaty®, 14 days after Spikevax®). 

Health Services

Questions (603)

David Cullinane

Question:

603. Deputy David Cullinane asked the Minister for Health his plans to expand the long-term illness scheme or to broaden the eligibility criteria for the long-term illness card; and if he will make a statement on the matter. [43312/21]

View answer

Written answers

The Long Term Illness (LTI) 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. There are no plans to extend the list of conditions covered by the Scheme at this time. However, a review of the current eligibility framework, including the basis for existing hospital and medication charges, will be carried out under commitments given in the Sláintecare Implementation Strategy. In the meantime, for people who are not eligible for the LTI scheme, there are other arrangements which protect them from excessive medicine costs.

Under the Drugs Payment Scheme, 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.

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. In addition, where an applicant is 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.

Finally, persons may also be entitled to claim tax relief on the cost of their medical expenses, including medicines prescribed by a doctor, dentist, or consultant. Relief is at the standard tax rate of 20%.

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