Tuesday, 19 Oct 2021

Written Answers Nos. 146-165

Disabilities Assessments

Questions (146)

Paul McAuliffe

Question:

146. Deputy Paul McAuliffe asked the Minister for Health his progress to date in lowering the waiting times for assessment of needs in Dublin 9 and 11;; and if he will make a statement on the matter. [50797/21]

Written answers

Minister of State at the Department of Health

As the Deputy's question relates to a service issue, it has been referred to the HSE for direct reply.

Health Services Staff

Questions (147)

Mark Ward

Question:

147. Deputy Mark Ward asked the Minister for Health the measures that have been put in place to retain clinicians in CHO7; and if he will make a statement on the matter. [50519/21]

Written answers

Minister for Health

In relation to the particular query raised, as this is a service matter I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Question No. 148 answered with Question No. 141.

Irish Blood Transfusion Service

Questions (149)

Neasa Hourigan

Question:

149. Deputy Neasa Hourigan asked the Minister for Health the work undertaken to date by the post-implementation surveillance monitoring group of his Department established to assess the impact of the change to blood donor deferral policies in 2017; and if he will make a statement on the matter. [50779/21]

Written answers

Minister for Health

The Blood Donation Deferral Surveillance Group was established to assess the impact, if any, on the incidence of transfusion transmitted infections, following the change to MSM and STI donor deferral policies in 2017. 

The Group includes representatives from the Irish Blood Transfusion Service, Health Protection Surveillance Centre, Public Health England and NHS Blood and Transplant (NHSBT). 

The Group met in September 2021.  The Group considered trends in notifications of HIV & STI in Ireland from 2015-2019, the findings of a 12-year review (2008-2020) by the IBTS of blood donors with confirmed HIV and syphilis infections, and the UK experience of changes in deferral policy. 

The Group agreed that there was no evidence of an adverse impact arising from the 2017 change in deferral policies, including the change in MSM deferral policy from a lifetime ban to a 12 month deferral (from last sexual encounter with a man).  

The work of the Group will contribute to the evidence base that can inform future decisions in relation to blood donor deferral policies.

Hospital Charges

Questions (150, 163)

Alan Farrell

Question:

150. Deputy Alan Farrell asked the Minister for Health the detail of the process to reduce hospital charges for persons under 18 years of age as referenced in Budget 2022; and if he will make a statement on the matter. [50824/21]

Jennifer Carroll MacNeill

Question:

163. Deputy Jennifer Carroll MacNeill asked the Minister for Health the detail of the commitment in Budget 2022 to introduce phased reduction of costs for children in hospital and their families; and if he will make a statement on the matter. [50814/21]

Written answers

Minister for Health

I propose to take Questions Nos. 150 and 163 together.

The Health Act 1970 (as amended) provides that all persons ordinarily resident in the State are eligible, subject to certain charges, to public in-patient hospital services including consultant services. Persons, irrespective of illness or condition, accessing public in-patient (including day case) services in a public hospital are liable for the statutory in-patient daily charge of €80 up to a maximum of €800 in any period of 12 consecutive months.

In addition, the Health (Out-Patient Charges) Regulations 2019 provide that, a charge shall be made for out-patient services provided at an emergency department (€100), a minor injury unit (€75) or any other facility providing similar-services, in respect of the first occasion the service is provided in relation to each episode of care.

Certain cohorts are exempt from these charges including:

- medical card holders;

- people receiving treatment for prescribed infectious diseases - including Coronavirus (Covid-19);

- people who are subject to 'long-stay' charges;

- children referred for treatment from child health clinics and school board examinations;

- people who are eligible for hospital services because of EU Regulations;

- women receiving maternity services;

- children up to 6 weeks of age;

- people with hepatitis C who have a Health Amendment Card;

- people who are part of the Redress Scheme for Women Resident in Certain Institutions.

The Government is committed to ensuring that care is accessible and affordable for the most vulnerable in society and therefore funding has been committed in Budget 2022 for measures to alleviate the financial burden of hospital charges incurred for children accessing care. Details of the proposed amendments to hospital charges for children will be announced in due course.

Home Care Packages

Questions (151)

Brendan Smith

Question:

151. Deputy Brendan Smith asked the Minister for Health the number of older persons on the waiting list for homecare support in each local health office area in CHO1; the corresponding figures for each area at the end of June 2020; and if he will make a statement on the matter. [50612/21]

Written answers

Minister of State at the Department of Health

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

Hospital Waiting Lists

Questions (152)

Richard Boyd Barrett

Question:

152. Deputy Richard Boyd Barrett asked the Minister for Health his plans to clear the outpatient waiting lists; the timeline for so doing; and if he will make a statement on the matter. [50800/21]

Written answers

Minister for Health

It is recognised that waiting times for scheduled appointments and procedures have been impacted in the last nineteen 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.

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.

On the 7th October I published the Acute Waiting List Action Plan. This plan, to run until December 2021, has a series of targeted measures that are designed to address the growth in waiting lists caused by Covid-19 and the cyber-attack.

In addition, my Department, the HSE and the NTPF are also working on a Multi Annual Waiting List Plan to bring waiting lists in line with Sláintecare targets over the coming years. This process will be overseen by a Ministerial Taskforce, chaired by the Secretary General of my Department and includes representatives from the HSE and National Treatment Purchase Fund. The plan will be informed by the lessons learned from the successful Vaccine Taskforce.   

For 2022 an additional allocation of €250 million, comprised of €200 million to the HSE and €50 million to the National Treatment Purchase Fund has been provided in respect of work to reduce hospital and community waiting lists. The €250 million will be used to fund additional activity in both the public and private sectors. The €50 million additional funding provided to the NTPF brings its total allocation for 2022 to €150 million, and as a consequence there will be a budget of €350 million available to support vital initiatives to improve access to acute hospitals and community health services.

Dental Services

Questions (153)

Colm Burke

Question:

153. Deputy Colm Burke asked the Minister for Health the measures his Department will take to reduce public orthodontic treatment waiting lists which are as high as six or seven years in the south south west region; if this treatment can be included under the treatment purchase scheme; and if he will make a statement on the matter. [50885/21]

Written answers

Minister for Health

The HSE provides orthodontic treatment to patients with the greatest need who have been assessed and referred for treatment before their 16th birthday. Through waiting list initiatives, the HSE also  procures orthodontic care through private service providers. Since 2016 approximately 2,000 patients have received treatment through this process.

The National Treatment Purchase Fund (NTPF) works with public hospitals, as opposed to with patients directly, to offer and provide the funding for treatment to clinically suitable long waiting patients who are on an inpatient/day case waiting list for surgery, having been referred on to such a list following clinical assessment by a consultant/specialist at an outpatient clinic.

The NTPF advise that they do provide treatment for patients who are awaiting procedures under the category of 'Dental/Maxilla-Facial Surgery'. The NTPF further advise that children can avail of treatment through the NTPF, including for dental procedures. The key criteria of the NTPF is the prioritisation of the longest waiting patients first. While the NTPF identifies patients eligible for NTPF treatment, it is solely on the basis of their time spent on the Inpatient/Daycase Waiting List. The clinical suitability of the patient to avail of NTPF funded treatment is determined by the public hospital.

The Northern Ireland Planned Healthcare Scheme, operational since 1 January 2021 on an administrative basis, enables persons resident in the State to access and be reimbursed for private healthcare, including orthodontic care, in Northern Ireland by the HSE, provided such healthcare is publicly available within Ireland. It should be noted that the scheme operates on parameters similar to the EU Cross Border Directive. Patients are advised to contact the HSE Cross Border Directive office directly for further information on individual applications and types of treatment available under the NI Planned Healthcare Scheme. 

Patients also continue to have access to health services under the EU Cross Border Directive Scheme in all other remaining EU/EEA countries. In the context of the Covid-19 pandemic, persons seeking to utilise these schemes should review and adhere to the public health guidance and restrictions in place at any point in time.

Health Services

Questions (154)

Mick Barry

Question:

154. Deputy Mick Barry asked the Minister for Health if he will consider extending access to free contraception to all persons that request it as per the recommendations of the Oireachtas Committee on the Eighth Amendment of the Constitution; the forms of contraception that will be available under the scheme; if he will consider a choice of contraception and for the scheme to be introduced ahead of the August 2022 target; and if he will make a statement on the matter. [50843/21]

Written answers

Minister of State at the Department of Health

The Programme for Government commits to providing free contraception for women, starting with the 17-25 age cohort.

Accordingly, funding for free contraception, starting with women aged 17-25, has been allocated in 2022. The initiative is gradually being introduced by age cohort, starting with younger women who are least likely to be financially independent and where cost has been shown to be a greater barrier to access contraception.

The scheme will provide for:

- The cost of prescription contraception;

- The cost of fitting and/or removal of various types of long-acting reversible contraception and administration of contraceptive injections plus any necessary checks, by medical professionals certified to fit/remove same;

- The cost of training and certifying additional medical professionals to fit and remove long-acting reversible contraception;

- The cost of a maximum of two consultations per annum with GPs and other doctors to discuss forms of contraception suitable for individual patients and to enable prescription of same.

It is envisaged that a wide range of contraceptive options, currently available to medical card holders, will be made available through this scheme. This includes contraceptive injections, implants, various types of intrauterine system (IUS) or device (IUD; commonly known as the coil), the contraceptive patch and ring, and various forms of oral contraceptive pill.

In order to give time to bring forward the necessary legislative proposals and ensure the implementation of service delivery arrangements through the appropriate areas of the healthcare system, it will not be possible to introduce the scheme ahead of the August 2022 target.

Health Services Staff

Questions (155)

Christopher O'Sullivan

Question:

155. Deputy Christopher O'Sullivan asked the Minister for Health the steps that are being taken to assist a service (details supplied) with recruitment; and if he will make a statement on the matter. [50791/21]

Written answers

Minister for Health

Notwithstanding its aim to support people to live where and with whom they choose as much as possible, and despite its efforts in this instance, it is understood that CoAction is temporarily relocating three people from their home in Béara to two other CoAction houses in Bantry and Skibbereen.  As soon as the recruitment is successful, the three individuals will return to their home in Béara.  

It is understood that a transition plan is in place for each individual based on his or her particular needs and supports.  All three will be moved by the end of October 2021.

The safety and protection of vulnerable people in the care of the State is paramount.  This Government’s primary concern is that their needs are being prioritised and addressed.  

Under Section 39 of the Health Act 2004 the HSE provides a grant to allow organisations to provide services similar or ancillary to the HSE.  CoAction West Cork is scheduled to receive over €9m in funding from the HSE in 2021 under Section 39 of the Health Act.  This is an increase from over €8m in 2020.

Co Action is a Section 39 organisation; it is privately owned and run.  Its terms and conditions of employment, once in line with employment legislation, are strictly between the employer and the employee. 

In Budget 2022, the Government has allocated an additional €105m to disability services, with a further €10m one-off funding.  The quantum of services to be provided and supported by the HSE will be considered as part of National Service Planning.

Disability Services

Questions (156, 186, 797)

Neale Richmond

Question:

156. Deputy Neale Richmond asked the Minister for Health the status of the evaluation carried out by the HSE on the services of a school (details supplied); and if he will make a statement on the matter. [50807/21]

Neale Richmond

Question:

186. Deputy Neale Richmond asked the Minister for Health the status of the re-implementation of services in a school (details supplied); and if he will make a statement on the matter. [50808/21]

Neale Richmond

Question:

797. Deputy Neale Richmond asked the Minister for Health if his attention has been drawn to ongoing issues regarding progressing disability services in a school (details supplied); and if he will make a statement on the matter. [45215/21]

Written answers

Minister of State at the Department of Health

I propose to take Questions Nos. 156, 186 and 797 together.

As the Deputy's questions relate to service issues they have been referred to the HSE for direct reply.

Vaccination Programme

Questions (157, 202)

Paul Murphy

Question:

157. Deputy Paul Murphy asked the Minister for Health the action he plans to take to ensure that those who suffered narcolepsy after receiving the pandemrix vaccine will receive appropriate compensation without court cases. [49533/21]

Paul Murphy

Question:

202. Deputy Paul Murphy asked the Minister for Health the action he has taken to date to ensure that those who suffered narcolepsy after receiving the pandemrix vaccine have received adequate compensation. [49534/21]

Written answers

Minister for Health

I propose to take Questions Nos. 157 and 202 together.

The State Claims Agency (SCA) has a statutory remit to manage personal injury claims on behalf of Delegated State Authorities including the Health Service Executive. The management of cases taken by persons who allege they developed Narcolepsy and/or Cataplexy as a result of receiving the H1N1 vaccine, Pandemrix, is delegated to SCA and, as such, the Government has no role in determining how these cases are conducted.

I understand, however, that the SCA has established a Scheme of Settlement in relation to this litigation whereby plaintiffs have the facility of resolving their claims through a formal mediation process with an ultimate right of appeal to a retired superior court judge. I am informed that the Scheme is functioning well and a number of cases have been successfully resolved. Other cases are in the process of resolution by the Scheme.

Health Strategies

Questions (158)

Niamh Smyth

Question:

158. Deputy Niamh Smyth asked the Minister for Health the additional funding being provided for the National Maternity Strategy in 2022; and if he will make a statement on the matter. [50614/21]

Written answers

Minister for Health

I would like to assure the Deputy that the issue of Women’s Health remains a key priority for me and for the Government. In line with commitments made in the Programme for Government, Budget 2022 commits a substantial financial investment of €31m to support women’s health projects. This includes investment in the implementation of the National Maternity Strategy, investment in gynaecology services and a doubling of the Women’s Health Fund from €5 million to €10 million.

National Maternity Strategy 

Funding of €8.66m has been allocated for the implementation of the National Maternity Strategy for 2022. Implementation of the Strategy is required to ensure standard, consistent models for the delivery of a national maternity service that reflects best available evidence and ensures that all pregnant women have appropriate and informed choice, as well as access to the right level of safe care and support 24 hours a day. The funding and the associated WTEs will ensure the continued roll out of the Strategy’s model of care and its 3 care pathways – Supported, Assisted and Specialised. 

Funding allocated for 2022 will permit the recruitment of an additional 99.5 WTEs into maternity services across the country. The posts will cover a variety of disciplines, including, obstetrics, neonatology, endocrinology, anaesthetics, dietetics, midwifery, physiotherapy and occupational therapy.  

These posts are required to ensure the Strategy’s vision of a new model of integrated, team-based care that provides increased choice to women while ensuring that every woman can access the right level of care, from the right professional, at the right time and in the right place, based on her needs. Continuing the phased implementation of the Strategy is vital to ensure that these objectives are met.  

Funding allocated to the Strategy in 2022 will ensure: 

- All maternity services will have a minimum of six permanent consultant posts thereby eliminating the need for the continued reliance on temporary and locum post holders and enabling sustainable built-in cover and on-call rotas; 

- Increased availability of medical specialists in the area of endocrinology, ensuring that all maternity services have at least one dedicated CMS in the area of diabetes care; 

- Expanded provision of out of hours consultant anaesthetist availability for maternity services; 

- AMP posts developed specifically in the management of high risk women; 

- Development of dedicated midwifery senior resources within maternity services dedicated to the area of foetal monitoring surveillance; 

- Development of two dedicated postnatal hubs targeted at supporting women for up to 14 days post birth and addressing many of the gaps and deficiencies identified by women in the area of postnatal care including education, breastfeeding supports, physiotherapy, emotional and physical supports; 

- Increased on-site presence of senior midwifery decision makers across a range of areas including community services, delivery suites, antenatal and postnatal wards;

- Support provided to national lead roles in NWIHP in the area of breastfeeding and antenatal education and obstetric emergencies with a view to strengthening training and education supports;  

- Increased access to key allied health professional services and supports including dietetics and medical social work; and improved care provided to neonates in line with the HSE’s Model of Care for Neonatal services.   

The additional funding in Budget 2022 will ensure continued implementation of the National Maternity Strategy into 2022 and beyond, building on the significant investment in 2021.  

Hospital Facilities

Questions (159)

Catherine Connolly

Question:

159. Deputy Catherine Connolly asked the Minister for Health the engagement he has had with Saolta with regard to the vision and a masterplan for the Merlin Park University Hospital site, including clarification on the building projects completed there in the past five years; the building projects currently under construction; the building projects for which planning permission has been given but which have not yet commenced and further planned projects; and if he will make a statement on the matter. [50803/21]

Written answers

Minister for Health

As the Health Service Executive is responsible for the delivery of public healthcare infrastructure projects, I have asked the HSE to respond to you directly in relation to this matter. 

Health Services

Questions (160)

Verona Murphy

Question:

160. Deputy Verona Murphy asked the Minister for Health the provisions his Department is taking for the implementation of a crisis resolution team for County Wexford; and if he will make a statement on the matter. [50624/21]

Written answers

Minister of State at the Department of Health

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

Home Care Packages

Questions (161)

Seán Haughey

Question:

161. Deputy Seán Haughey asked the Minister for Health the number of older persons on the waiting list for homecare support in each local health office area in CHO9; the corresponding figures for each area at the end of June 2020; and if he will make a statement on the matter. [50623/21]

Written answers

Minister of State at the Department of Health

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

Hospital Facilities

Questions (162)

Pa Daly

Question:

162. Deputy Pa Daly asked the Minister for Health the status of each capital expenditure projects planned with respect to University Hospital Kerry; and the timeline for their completion. [50809/21]

Written answers

Minister for Health

As the Health Service Executive is responsible for the delivery of public healthcare infrastructure projects, I have asked the HSE to respond to you directly in relation to this matter. 

Question No. 163 answered with Question No. 150.

Hospital Services

Questions (164)

Maurice Quinlivan

Question:

164. Deputy Maurice Quinlivan asked the Minister for Health the steps being taken to address the overcrowding of the emergency department at University Hospital Limerick and to mitigate against the increased number of patients presenting at the emergency department; and if he will make a statement on the matter. [50769/21]

Written answers

Minister for Health

The Government has provided a significant investment of €1.2bn in budget 2021 to expand capacity, increases services and support reform and this level of investment is being maintained in budget 2022.  An additional €22m is also being allocated in to enhance specific additional winter initiatives in 2022.  UL Hospitals Group and Community Healthcare Mid-West have formalised a governance structure to deliver on the investment in community care, hospital avoidance, chronic disease and older persons.

The Emergency Department at University Hospital Limerick (UHL) is one of the busiest EDs in the country with 65,824 ED presentations in 2020. The UL Hospital Group advised that they continue to follow the escalation plan, which includes additional ward rounds, accelerating discharges and identifying patients for transfer to their Model 2 hospitals. 

It is acknowledged that acute bed capacity shortages in the Mid-West are a major contributor to overcrowding at the ED in UHL. The provision of 132 additional beds in UHL HG over the past year has been a significant step in addressing this.

This includes a new 60 bed block, providing modern, single-room inpatient accommodation. As well improving patient experience in terms of comfort, privacy, and dignity; it improves infection prevention and control capabilities, including better isolation of patients and improved patient flow at the hospital.

UHL also added a 24 Bed, single room, Rapid Build Ward; and the reconfigured 14 bed HDU Unit to accommodate Thrombosis & Coagulation.

In addition the new 96 bed inpatient ward block project has now progressed through the detailed design stage and is due to go to tender in the coming weeks.

An increase in daily patient slots in the Medical Assessment Unit at Ennis Hospital is enabling

GPs to refer an additional 48 patients every week and further reduce pressure on the

Emergency Department at University Hospital Limerick.

Health Services

Questions (165)

Duncan Smith

Question:

165. Deputy Duncan Smith asked the Minister for Health his views on and the status of the progression of the opening of dedicated menopause clinics as of October 2021; and if he will make a statement on the matter. [50821/21]

Written answers

Minister for Health

The Government recognises that menopause is a key health issue for women in Ireland today, and work is underway to drive progress in this area which is being driven by the Women’s Health Taskforce. The Taskforce was convened in September 2019, to improve health outcomes and health experiences for women and girls.

I am committed to progress in the area of women's health, and menopause as a priority within that. In September, I announced my commitment to establish dedicated specialist menopause clinics across Ireland. These clinics will form a core part of a new approach to menopause care for women in Ireland and will be supported by enhanced community and primary care supports as well as the publication of targeted and trusted sources of information for women experiencing menopause.

The first phase of change will include the development of a dedicated specialist menopause clinic, in the National Maternity Hospital, Holles Street this year. The clinic will be multidisciplinary supported by GPs with a certified special interest in the area of menopause and clinical nurse/midwife specialists. In addition to seeing women who meet the clinical criteria for referral to the service, the clinical team will also provide advice and guidance to GPs in the community to support the effective management of menopausal symptoms for women closer to home within primary care. Budget 2022 has supported  further developments in menopause care by increasing the number of specialist menopause clinics from 1 clinic to 4 clinics nationally.  

Work is underway to open the specialist menopause clinic in the National Maternity Hospital, with administrative and clinical posts currently in the process of being filled. The clinic is expected to be operational in November.