Written Answers Nos. 242-260
242. Deputy Róisín Shortall asked the Minister for Health the number of children and young persons on a waiting list for scoliosis surgery; the current wait time; and if he will make a statement on the matter. [51481/21]
View answerI sincerely regret that children can experience a long waiting time for hospital appointments and treatment, and I remain conscious of the burden that this places on them and their families.
My priority as Minister for Health, and that of this Government, is to improve waiting times for all patients accessing hospital treatment, and reducing the paediatric waiting list for orthopaedic procedures remains a priority within that.
My Department, the HSE and the National Treatment Purchase Fund (NTPF) are working on a Multi Annual Waiting List Plan to address waiting lists and bring them 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 including representatives from the HSE and National Treatment Purchase Fund. It will take the learnings from the achievements of the Vaccine Taskforce to inform the plan.
An additional €250 million is being provided in Budget 2022 to improve access to care across the health system.
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.
The cyber-attack in May 2021 in particular, caused significant disruption to the orthopaedic service and all services across the Children’s Health Ireland Hospital Group. Children's Health Ireland advise that without access to a patient’s full history and previous diagnostic investigations, it was not considered safe to proceed without all electronic support systems in place. This impacted patients with complex needs in particular, and restricted the patient cohort that could safely proceed with surgery during this time.
Most systems are now back up and running across CHI sites, but back-loading of information is ongoing, and this continues to have an impact on waiting lists and the number of surgeries completed.
Despite the impact of the pandemic and the cyberattack Children’s Health Ireland advise that as of the end of September 2021, 266 spinal surgeries had been carried out which is an increase of 41 compared to the same period last year.
CHI remain committed to increasing activity levels and examining innovative methods to improve access to all specialities. For example, additional theatre sessions are being held in Cappagh National Orthopaedic Hospital, for non-complex, age-appropriate orthopaedic patients.
CHI also continues to develop the Advanced Clinical Triage clinic model in City West. Active Clinical Triage is a system which has been adapted for use within the paediatric orthopaedic unit at CHI Crumlin and its purpose is to reduce the overall orthopaedics out-patient waiting list, starting with the longest waiting clinically appropriate referrals.
A new Orthopaedic Consultant with a special interest in neuromuscular conditions started in Temple Street in September which should also enable the use of additional theatre capacity and support additional capacity as part of the Cappagh Kids programme.
Officials in the Department of Health remain in regular contact with CHI regarding scoliosis services. CHI have advised that all patients with a diagnosis of scoliosis require a pre-operative work-up prior to spinal surgery, including multiple diagnostic investigations and review by a multi-disciplinary team. The plan of care which is implemented for each patient is tailored to best meet the patient's clinical requirements. It is the responsibility of the treating Consultant to clinically prioritise patients for surgery on the waiting list.
In relation to the specific issue raised by the Deputy, as this is an operational matters, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
243. Deputy Jennifer Carroll MacNeill asked the Minister for Health when the recruitment of epilepsy nurse specialist posts as laid out in the pregnancy prevention programme is to be completed; and if he will make a statement on the matter. [51485/21]
View answerAs this question relates to operational matters for the Health Service Executive (HSE), I have asked that the HSE responds to the Deputy directly.
244. Deputy Mark Ward asked the Minister for Health if he will provide a comprehensive report on the mental health budget for 2021: the budget allocated; the way in which it was spent; the services it was spent on; the details of overspends or underspends; and if he will make a statement on the matter. [51492/21]
View answer248. Deputy Mark Ward asked the Minister for Health when the 2021 mental health budget was released to his Department: the amount which was not released; and if he will make a statement on the matter. [51496/21]
View answer249. Deputy Mark Ward asked the Minister for Health the amount of funding from the mental health budget which has been withheld from the HSE by his Department in 2021; and if he will make a statement on the matter. [51497/21]
View answerI propose to take Questions Nos. 244, 248 and 249 together.
2021 saw a then record budget for mental health of over €1.114 billion, including €23 million to commence implementation of many of the short-term recommendations of Sharing the Vision in 2021 and the HSE National Service Plan (NSP) and €15 million to address the additional challenges posed by Covid-19.
An additional €10 million in once off funding has been made available for further investment in mental health services in 2021, with a particular emphasis on community and voluntary based supports.
As part of the annual budgetary process the Department releases funding for specific new initiatives set out in the HSE's National Service Plan subject to the receipt, review and approval of implementation plans in relation to each initiative.
Of the €23 million for new initiatives, €8.737 million has been released to the HSE. This funding has enabled the HSE to progress specific initiatives, including crisis resolution teams, peer support programmes, individual placement supports, development of the national clinical programmes, the recently launched DBT training programme and the recruitment of a bereavement co-ordinator under Connecting for Life , the National Strategy to Reduce Suicide.
The Deputy will be aware that the pandemic and the cyber-attack have caused difficulties across the entirety of the health service, including Mental Health Services. Recruitment and retention of staff also remain difficulties that are continually being addressed through national and international advertising campaigns.
245. Deputy Mark Ward asked the Minister for Health the percentage of the health budget that is dedicated to mental health provision in each of the years 2019 to 2022; and if he will make a statement on the matter. [51493/21]
View answer254. Deputy Mark Ward asked the Minister for Health the total mental health budget between 2020 to 2022, in tabular form; and if he will make a statement on the matter. [51502/21]
View answerI propose to take Questions Nos. 245 and 254 together.
The final allocation for all health service areas is set out in the relevant HSE National Service Plans. The Mental Health Services allocations for the years 2019 – 2022, as set out in the relevant Plans, are set out in the table below. The precise allocation for 2022 will be finalised as part of the National Service Plan process for 2022:
|
Year |
Allocation per NSP |
% of Health Budget |
|
2019 |
€0.987b |
6.3% |
|
2020 |
€1.031b |
5.2% |
|
2021 |
€1.114b |
5.4% |
|
2022 |
€1.149b |
5.4% |
An additional €10 million was announced last week, as a once off funding measure, for investment in mental health services in 2021, with a particular focus on supporting the community and voluntary pillar.
Budget 2022 highlights the Government’s continued commitment to mental health by the allocation of an additional €47 million to the HSE Mental Health Services Budget, comprising €24 million for new developments, €13 million for existing level of service and €10 million in once off funding for COVID-19.
246. Deputy Mark Ward asked the Minister for Health the funding available from Budget 2022 for community mental health services that do not receive funding through the HSE or other Departments; and if he will make a statement on the matter. [51494/21]
View answerThe development of all aspects of mental health services remains a priority for Government. This is reflected in the current Programme for Government, Sharing the Vision - A Mental Health Policy for Everyone, and the HSE National Service Plans.
2022 will see another record budget of €1.149 billion for mental health services. This includes an additional €47 million for next year and comprises €24 million for new developments, €13 million for existing levels of service and €10 million in once off funding for mental health initiatives in response to Covid.
An additional €10 million once off funding has been made available for further investment in mental health services in 2021, with a particular emphasis on community and voluntary based supports. Plans for this funding are currently being finalised by Minister Butler and the Department in liaison with the HSE.
Of note, multiple funding streams are available from other departments and agencies for mental health supports. For example, Pobal managed funds and the LEADER fund.
The Government as whole is committed to ensuring continued investment in mental health so that we can further improve and enhance our mental health services and supports.
247. Deputy Mark Ward asked the Minister for Health the areas in which the €13 million allocated for existing mental health services in Budget 2022 will be spent; and if he will make a statement on the matter. [51495/21]
View answerBudget 2022 saw another record budget allocation for mental health services of €1.149 billon. This is an increase of €47 million on 2021, comprising €24 million for new developments, €13 million for existing level of service and €10 million for mental health initiatives in response to Covid.
The €13 million for existing level of service has been allocated to the HSE as part of its overall budget for core mental health services and details of the services to be provided will be finalised in the context of the National Service Plan 2022 process.
250. Deputy Mark Ward asked the Minister for Health the monies returned unspent to the Exchequer from the HSE CAMHS budget in each year from 2019 to 2021, in tabular form; and if he will make a statement on the matter. [51498/21]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
251. Deputy Mark Ward asked the Minister for Health the funds returned unspent to the Exchequer from the budget of his Department in 2018 and 2019, in tabular form; and if he will make a statement on the matter. [51499/21]
View answerThe Deputy should note that no funding was returned to the exchequer from the Department of Health (Vote 38) in 2018 or 2019.
In 2018 and 2019 additional funding was approved for Vote 38 by the Oireachtas through a Supplementary Estimate.
252. Deputy Mark Ward asked the Minister for Health the way in which the €24 million for new developments in Budget 2022 will be spent; and if he will make a statement on the matter. [51500/21]
View answerBudget 2022 saw another record budget allocation for mental health services of €1.149 billon. An additional €47 million has been added to the Mental Health Services budget, comprising €24 million for new developments, €10 million for mental health initiatives in response to Covid and €13 million for existing level of service.
Separately, another €10 million is being made available in 2021, aimed at supporting the community and voluntary pillar in the mental health sector.
The €24 million is being prioritised for the continued development of mental health services, including out of hours supports, CAMHS and mental health clinical programmes. It provides for the recruitment of 350 whole time equivalent staff. Mental health services for older people will also be developed, in line with the model of care for specialist mental health services for older people that will be piloted next year.
€6 million will be used to continue to enhance the capacity of community mental health teams, with a particular emphasis on CAMHS, while there will be over €1.4 million in new funding for crisis resolution services. Another €1.15 million will be allocated to continue the roll out of specialist eating disorder teams in CHOs 1, 3, 5 and 6. Other initiatives include recovery focused supports, including peer supports, employment supports and recovery colleges.
The details of the initiatives to be funded will be finalised as part of the National Service Plan process.
253. Deputy Mark Ward asked the Minister for Health if he will report on Sharing the Vision recommendations for Budget 2020 and 2021; the status of each recommendation; and if he will make a statement on the matter. [51501/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
255. Deputy Fergus O'Dowd asked the Minister for Health if he plans to update the National Positive Aging Strategy given that it has not been updated in over eight years; and if he will make a statement on the matter. [51511/21]
View answerThe National Positive Ageing Strategy is a high level document outlining Ireland’s vision for ageing and older people and the national goals and objectives required to promote positive ageing. It is an over-arching cross-departmental policy that has influenced policy and service delivery across Government since inception.
Significant developments have been, and continue to be, made in promoting positive ageing since the Strategy launched in 2013. In relation to the Programme for Government commitment to an age friendly Ireland progress is being made on commitments to increase home and community supports and housing options for older people. In particular, Sláintecare which envisages older people being supported to live well in their own homes for as long as possible sets out an overarching vision for care in our community and enabling older people to live longer at home. New projects such as the Healthy Age Friendly Homes Programme, the establishment of a Statutory Home Support Scheme, Integrated Care Packages for Older People (ICPOP) are just some examples of the progress we are making across government, agencies and with stakeholders in the community to increase the positive experience of ageing. The establishment of Age Friendly Ireland as a shared service for older people nationally is a further significant achievement.
Since the National Positive Ageing Strategy my Department has developed a significant body of research to inform an evidence based approach to policy making for older people in partnership with the Irish Longitudinal Study on Ageing (TILDA) and the research initiative set up on foot of the Positive Ageing Strategy i.e. HaPAI.
Across Government we will continue to prioritise improvements for older people in Ireland by focusing on the effective implementation and delivery of outcomes envisaged in Sláintecare, Housing For All and other focused strategies such as the National Dementia Strategy.
256. Deputy Fergus O'Dowd asked the Minister for Health his views on whether nutrition and hydration plays an important role in positive aging; if so, if he will commit to the inclusion of nutrition and hydration going forward; and if he will make a statement on the matter. [51512/21]
View answerPositive aging is an issue I am very interested in and for that reason, I requested the Food Safety Authority of Ireland ("FSAI") Scientific Committee to prepare a report on the Scientific Recommendations for Food- Based Dietary Guidelines for older people aged 65 and over. Hydration is also included in these recommendations which were published earlier this year. Healthy Ireland in my Department are developing nutrition resources (including advice on hydration) for this age group based on the FSAI scientific recommendations. These resources will be available early in 2022.
257. Deputy Jim O'Callaghan asked the Minister for Health if it is intended to recruit more neurology nurse specialists across the country; and if he will make a statement on the matter. [51522/21]
View answerIn 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.
258. Deputy Cian O'Callaghan asked the Minister for Health if fibromyalgia will be recognised as a disability and a long-term illness; and if he will make a statement on the matter. [51524/21]
View answerFibromyalgia is a condition characterized by severe pain, fatigue and stiffness, among many other symptoms. Fibromyalgia can be a difficult condition to diagnose because there is no specific test and the symptoms can be similar to those of other conditions. Treatment often requires interventions from various medical specialists for management of symptoms as they arise. Fibromyalgia is not classified as a disability and there are currently no plans for its reclassification.
The Long Term Illness 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 Long Term Illness 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.
The HSE afford applicants the opportunity to furnish supporting documentation to determine whether undue hardship exists and to fully take account of all relevant circumstances that may benefit them in assessment, including medical evidence of costs and certain expenses.
In circumstances where an applicant is still 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.
259. Deputy Cian O'Callaghan asked the Minister for Health if he will include chronic pain such as that suffered by persons with fibromyalgia as criteria to apply for the medical cannabis access programme; and if he will make a statement on the matter. [51525/21]
View answerThe Health Products Regulatory Authority’s “Cannabis for Medical Review Use – A Scientific Review” advised that treatment with cannabis is only permitted under a controlled access programme for the treatment of patients with;
a. Spasticity associated with multiple sclerosis resistant to all standard therapies and interventions whilst under expert medical supervision;
b. Intractable nausea and vomiting associated with chemotherapy, despite the use of standard anti-emetic regimes whilst under expert medical supervision;
c. Severe, refractory (treatment-resistant) epilepsy that has failed to respond to standard anticonvulsant medications whilst under expert medical supervision.
The HPRA did not consider that the available evidence supported the use of cannabis in other medical conditions.
Subsequently the Minister for Health established an Expert Reference Group to advise on the development of a Medical Cannabis Access Programme. This Group developed detailed Clinical Guidelines for the MCAP to be followed by clinicians, which contained inter alia guidance on ingredient combinations that are recommended for each of the three indications included in the MCAP
The Department is currently working to commence a new clinical review that will continue the work of the previous clinical expert group. This review will seek to build on evidence found in the earlier study and will assess if there is new information to support the addition of any other clinical indications to the MCAP.
260. Deputy Joe O'Brien asked the Minister for Health if he has examined the regulations and legislation that apply to cannabis use for medical conditions and palliative care having regard to the experience in Northern Ireland and Great Britain as set out in the Programme for Government; and if he will make a statement on the matter. [51530/21]
View answerThe Programme for Government Commitment is to “Examine the regulations and legislation that apply to cannabis use for medical conditions and palliative care having regard to the experience in Northern Ireland and Great Britain”
Having set out the current frameworks in relation to access medicinal cannabis products in Ireland, in order to progress this commitment it will be necessary to liaise with colleagues in Northern Ireland and Great Britain to examine the legislation and regulations in place, how their legislation has been implemented, what they have learned from both and where that can be applied in the Irish context.
Officials in my Department are have already met with their counterparts in the UK Department of Health and Social Care in order to commence the examination of the regulations and legislation. It is planned that officials from both Departments will meet on a regular basis to exchange information.
