Written Answers Nos. 632-651
632. Deputy James O'Connor asked the Minister for Health if his Department is currently engaged in retaining any of the existing services other than residential care in the Owenacurra Mental Health Facility in Midleton, County Cork; and if he will make a statement on the matter. [46070/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
633. Deputy Mary Lou McDonald asked the Minister for Health the reason for removal of school based clinical supports for students attending a school (details supplied) in County Dublin; and if he will make a statement on the matter. [46072/21]
View answer634. Deputy Mary Lou McDonald asked the Minister for Health the engagement the HSE undertook with a school (details supplied) in County Dublin in advance of the decision to remove school based clinical supports; and if he will make a statement on the matter. [46073/21]
View answer635. Deputy Mary Lou McDonald asked the Minister for Health if he will urgently address the need for provision of school based clinical supports for students attending a school (details supplied) in County Dublin; and if he will make a statement on the matter. [46074/21]
View answerI propose to take Questions Nos. 633 to 635, inclusive, together.
As these are service matters, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
636. Deputy Mary Lou McDonald asked the Minister for Health his views on the removal of school based clinical supports for students who have complex disabilities attending a school (details supplied) in County Dublin; and if he will make a statement on the matter. [46075/21]
View answerAs I said in the Topical Issue debate on this matter on September 21st in the House, that having made enquiries with the HSE, I have been informed that the pre-covid allocation Whole Time Equivalent levels based on the information given by St. John of Gods in April 2021 is as follows:
- Occupational Therapist - 0.4, which is equivalent to 2 days a week.
- Senior Physiotherapist - 0.38, which is equivalent to approximately 2 days a week.
- Speech and Language Therapist - 0.2, which is equivalent to approximately 1 day a week.
I’m informed by the HSE that the level of support as indicated by St. John of Gods is now being provided by the Children’s Disability Network Team assigned to the school and that there has been no removal of school based clinical supports for students.
637. Deputy Mary Lou McDonald asked the Minister for Health the engagement that took place with a school (details supplied) in County Dublin regarding the implementation of the progressing disability services for children and young persons programme; and if he will make a statement on the matter. [46076/21]
View answerAs the implementation of the Progressing Disability Services for Children and Young Persons Programme is an operational matter, the Deputy's question has been referred to the HSE, for direct reply as soon as possible.
638. Deputy Mary Lou McDonald asked the Minister for Health if he will urgently liaise with his Ministerial colleagues regarding the provision of school based clinical supports for students who have complex disabilities attending a school (details supplied) in County Dublin; and if he will make a statement on the matter. [46077/21]
View answerAs the provision of school based clinical supports for students who have complex disabilities is an operational matter, the deputy's question has been referred to the HSE for direct reply, as soon as possible.
639. Deputy Michael Creed asked the Minister for Health the progress being made with regard to supports for an association (details supplied) with regard to a lifelong pathway of care for those with Prader-Willi syndrome including access to appropriate respite service; and if he will make a statement on the matter. [46080/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
640. Deputy Alan Kelly asked the Minister for Health the number of dentists that have withdrawn from the medical card scheme in each of the years 2016 to 2020 and to date in 2021, in tabular form. [46091/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
641. Deputy Cathal Crowe asked the Minister for Health if his Department and the National Immunisation Advisory Committee have undertaken a scientific analysis on the possibility of the ivermectin drug being used as a Covid-19 therapy; and if he will make a statement on the matter. [46092/21]
View answerThe 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.
642. Deputy Seán Crowe asked the Minister for Health if the HSE has returned to full ICT functionality; and if not, the estimated date for achieving this. [46110/21]
View answerI have been advised by the HSE that while the vast majority of ICT systems have recovered to full functionality, some remedial work is required on a small number of older legacy ICT systems and this work is actively being addressed.
As the timeframe for achieving full functionality is a service matter, I have asked the Health Service Executive to respond to the deputy directly.
643. Deputy Colm Burke asked the Minister for Health the progress that has been made to date on the roll-out of community hubs for cardiology services in Cork city and county as part of Sláintecare; the status of same and of the plans going forward; and if he will make a statement on the matter. [46119/21]
View answerAs this matter falls within the operational responsibility of the HSE, it has been referred there for direct reply.
644. Deputy Gino Kenny asked the Minister for Health the estimated full year health and well-being budget for 2022, including for a child and well-being service. [46121/21]
View answerThe funding allocation for Health and Wellbeing for 2022 will be outlined in the October budget announcement.
645. Deputy Gino Kenny asked the Minister for Health the estimated full year cost in 2022 of adding 1,000 beds to the acute hospital network. [46122/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
646. Deputy Gino Kenny asked the Minister for Health the estimated full year cost in 2022 of clearing waiting lists for gender reassignment. [46123/21]
View answerIt is recognised that waiting times for scheduled appointments and procedures have been impacted in the last eighteen 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 associated curtailment of acute hospital services, coupled with the ransomware attack of May 2021, has impacted waiting times. However, the HSE advise that acute services are now almost all fully restored to pre cyber-attack levels, and are operating in line with relevant Covid protocols.
My Department, the HSE and the National Treatment Purchase Fund (NTPF) are focusing on improving access to elective care in order to reduce waiting times for patients. These plans include increased use of private hospitals, funding weekend and evening work in public hospitals, funding “see and treat” services where minor procedures are provided at the same time as outpatient consultations, providing virtual clinics and increasing capacity in the public hospital system.
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 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.
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.
647. Deputy Gino Kenny asked the Minister for Health the estimated full year cost in 2022 of clearing waiting lists for autism assessment. [46124/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
648. Deputy Mattie McGrath asked the Minister for Health when the changes to the fair deal scheme as legislated for in the Nursing Homes Support Scheme (Amendment) Act 2021 will become operational; the current position for family farms and businesses; if those who are applying for the scheme presently are subject to the conditions set out in the Act; if the new proposed terms will be available to current applicants retrospectively; if the HSE nursing home support scheme office and staff have been briefed on the new measures; and if he will make a statement on the matter. [46127/21]
View answerThe NHSS, commonly referred to as 'Fair Deal', is a system of financial support for people who require long-term residential care. The primary legislation underpinning the NHSS is the Nursing Home Support Scheme Act 2009. Participants in the NHSS contribute to the cost of their care according to their means while the State pays the balance of the cost. The Scheme aims to ensure that long-term nursing home care is accessible and affordable for everyone and that people are cared for in the most appropriate settings.
It is recognised that the Act, in its current form, did not place caps on the financial assessment of family owned and operated farms or businesses when calculating the means to pay for nursing home care. This places a potentially onerous burden on family successors and could challenge the future viability of these productive assets.
Therefore, the Department of Health proposed a policy change to the Scheme, to cap contributions based on farm and business assets at three years where a family successor commits to working the productive asset. The stated policy objective of the legislation is to introduce additional safeguards in the Scheme to further protect the viability and sustainability of family farms and businesses that will be passed down to the next generation of the family. These changes were mad through the Nursing Homes Support Scheme (Amendment) Bill, which was signed into law by the President 22 July 2021 and will come into effect 90 days later, on the 20 October 2021.
The principal amendment introduced under the Act extended the three-year cap on contributions based on farm and business assets at three years where an appointed family successor commits to working the productive asset for a period of 6 years. To be considered for the 3-year cap, the legislation requires that an asset owned by an applicant for the Scheme or recently transferred to a family member is a productive family asset that has been actively worked by a family member for a significant period of time in advance of the person entering care.
For the purposes of calculating the three-year period after which contributions will be capped under the amendment, time already spent in care when the amendment comes into force will be taken into account. This means that a person who entered nursing home care three or more years ago should be able to benefit from the relief under the amendment when it comes into force, provided they can meet the other conditions.
However, the amendment does not provide for any retrospective relief or refunds on contributions to care made before the amendment comes into operation. Retrospective application of the proposed legislative changes would create a challenging precedent, involving high legal and administrative costs and risks, in attempting to apply retrospectively a complex set of conditions. It would also introduce a degree of inequity where conditions would be imposed in the past, with only some people in a position to satisfy those – as then unknown – conditions.
The HSE Nursing Home Support Scheme Office has been involved throughout the development of the legislation as the responsible operational body. Appropriate training and updated guidance is being provided to staff involved in administering the scheme, and necessary changes to IT systems are being implemented.
649. Deputy David Stanton asked the Minister for Health the number of persons currently awaiting residential services and treatment with respect to the national clinical programme for eating disorders; and if he will make a statement on the matter. [46134/21]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
650. Deputy Neale Richmond asked the Minister for Health if the progressing disability services programme has been stopped in respect of its application to special schools and that special schools that heretofore had school based clinicians prior to the programme will continue to have clinicians based on site in accordance with the advice given to the HSE in the December 2009 Report of the National Reference Group on Multidisciplinary Disability Services for children aged 5 to 18; if this has been confirmed with special schools throughout Dublin city and county; and if he will make a statement on the matter. [46135/21]
View answer651. Deputy Neale Richmond asked the Minister for Health if all special schools previously being brought under the progressing disability services programme will receive the same number of clinicians of the same grade and same skill set specialisation based on-site for the same number of clinical hours, not allocated hours, as they had pre-Covid-19; and if he will make a statement on the matter. [46136/21]
View answer652. Deputy Neale Richmond asked the Minister for Health if his attention has been drawn to the fact that a school (details supplied) was initially told that it would not lose services, after the pausing then stopping of the progressing disability services policy applying to special schools has had a reduction in their service provision; and if he will make a statement on the matter. [46137/21]
View answerI propose to take Questions Nos. 650 to 652, inclusive, together.
As these are operational matters, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
