Written Answers Nos. 345-354
345. Deputy Alan Dillon asked the Minister for Health his plans to ensure each pregnant woman diagnosed with gestational diabetes in County Mayo has access to a diabetes doctor and clinic in Mayo University Hospital; the number of doctors available to women in this category in the county; and if he will make a statement on the matter. [51904/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
346. Deputy Jennifer Carroll MacNeill asked the Minister for Health the details of the disbursement of the €31 million women’s health package in Budget 2022; and if he will make a statement on the matter. [51905/21]
View answerBudget 2022 allocated €30.8m in additional funding to specific women's health initiatives for 2022. This funding comprises: €9m for the rollout of free contraception for women aged 17-25; €8.7m for the continued implementation of the National Maternity Strategy; €5.3m for the provision of gynaecology services; €1.3m for perinatal genetics; €0.7m for the Period Poverty Implementation Group; €0.5m for the establishment of an Obstetric Event Support Team; €0.3m for sexual assault treatment units; and €5m for the Women's Health Fund for the implementation of the Women’s Health Action Plan and other priorities recommended by the Women’s Health Taskforce.
347. Deputy Jennifer Carroll MacNeill asked the Minister for Health the way capacity issues will be addressed with the extension of free general practitioner care to children aged six and seven years of age; and if he will make a statement on the matter. [51906/21]
View answerIncreasing access to GP care without charges for children is an important healthcare measure that will remove a potentially prohibitive cost barrier to accessing GP care and will help to improve children’s health as they develop.
The expansion of GP care without fees to all children aged 12 years and under is planned on a phased basis to limit the impact the expansion might have on GP capacity; the initial stage of this phased expansion to be the provision of GP care without fees to all children aged 6 and 7.
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. This date will be determined following consultation with the IMO.
The Government has undertaken several measures in recent years to increase the sustainability of general practice and its attractiveness as a career. Under the 2019 GP Agreement investment in general practice is set to increase by approximately 40% (€210 million) between 2019 and 2023, providing for significant increases in capitation fees for participating GPs. Improvements to maternity and paternity leave arrangements have also been made, and supports introduced for rural practices and practices in areas of urban deprivation.
The number of entrants to GP training has increased from 120 in 2009 to 233 this year, with large increases made in recent years. Further increases are expected as responsibility for training has transferred from the HSE to the Irish College of General Practitioners.
348. Deputy David Cullinane asked the Minister for Health if he will provide definitive date for the implementation of a full 24/7 primary percutaneous coronary intervention service at the University Hospital Waterford; and if he will make a statement on the matter. [51908/21]
View answerIn 2016, the Herity Report concluded that the needs of the effective catchment population of University Hospital Waterford (UHW) could be accommodated from a single Cath lab and recommended that the operating hours of the existing Cath lab should be extended.
Discussions are still on-going to commence extended working days in the Cath Lab in University Hospital Waterford.
The Programme for Government commits to the delivery of a second Cath lab in University Hospital Waterford. The HSE has advised that funding was allocated in the 2019 Capital Plan for the provision of a second Cath lab at University Hospital Waterford and planning permission was received from Waterford City and County Council in January 2020.
The HSE has further advised that the Contractor for the construction of the new Cath Lab at UHW was formally appointed on 25th March 2021. The project commenced on 17th May 2021 with a 13 month works programme. The project could not commence earlier due to levels of Covid Infection presenting at UHW.
It is expected the main Contractor will hand over the project by the end of June 2022. Equipping and commissioning will follow for a period of 2 months and the Cath Lab is expected to be available for operational use from September 2022 onwards.
The HSE has advised that discussions are on-going in relation to the 12 bed day ward to support the second Cath Lab and that UHW will commence recruitment of the required staff for the Second Catheterisation Laboratory in the coming months
The Herity Report also recommended that the current 9 to 5 provision of emergency pPCI services at UHW should cease to allow the hospital to focus on the much larger volume of planned work. The then Minister for Health asked the Department to address the implications of this recommendation by arranging for a National Review of Specialist Cardiac Services.
The National Review of Specialist Cardiac Services commenced in January 2018. While substantial progress has been made on the Review, the COVID-19 Pandemic has impacted on its progress. Work has now recommenced on the Review to progress this over the coming months. As part of this, the Steering Group, under the Chairship of Prof Philip Nolan, has reconvened and a meeting was held on 20th September.
To assist with current interventional cardiology diagnostic elective procedures, UHW has set out a ‘Service Level Agreement’ with UPMC in Waterford. This is a three day week service agreement to assist with scheduled care capacity.
350. Deputy Éamon Ó Cuív asked the Minister for Health if it is intended to provide €45 million extra funding to the HSE for 2022 specifically ringfenced for cancer services to continue to service the National Cancer Strategy; and if he will make a statement on the matter. [51972/21]
View answerThe implementation of the National Cancer Strategy is a Programme for Government commitment and is part of the implementation of Sláintecare. We have seen significant progress on the implementation of the Strategy over the past four years, with clear evidence-based policy direction from my Department and strong implementation by the HSE's National Cancer Control Programme (NCCP).
As part of Budget 2021, an extra €20m was allocated for the continued implementation of the National Cancer Strategy this year. This funding is being used to facilitate developments across prevention, diagnosis, treatment and patient supports. Additional funding of €12m was also allocated this year for the restoration of cancer services to 95% of 2019 (pre-Covid) levels. This funding is being used to support hospitals in addressing backlogs, to extend clinic times, to provide additional clinics, to increase diagnostic capacity and to provide locum/temporary support.
I have now secured a further €20m in Budget 2022 to progress the delivery of the National Cancer Strategy and this will have a significant impact on access to cancer diagnostics, treatment and support to patients across their cancer journey.
351. Deputy Róisín Shortall asked the Minister for Health if he will report on the contact tracing which is currently taking place for Covid-19 cases; and the main findings in respect of the key settings in which transmission is taking place. [51973/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
352. Deputy Róisín Shortall asked the Minister for Health when NPHET informed the Government that vaccinations alone would not control Covid-19; and the way in which the Government has responded to that information. [51974/21]
View answerThroughout the pandemic, NPHET has consistently advised on the importance of the continued application of a range of non-pharmaceutical interventions in addition to the vaccination programme as part of our national strategy for the management of COVID-19. These include the importance of self-isolating when symptomatic and diagnosed with COVID-19, wearing of masks in a range of settings, the importance of ventilation, physical distancing, and good hand and respiratory hygiene. These core public health measures have been the bedrock of our response to COVID-19 and continue to form a core component of Government policy and public communications.
The NPHET letters outlining advice to Government over the course of the pandemic are available here www.gov.ie/en/collection/ba4aa0-letters-from-the-cmo-to-the-minister-for-health/
353. Deputy Róisín Shortall asked the Minister for Health the reason for the absence of reference to the importance of ventilation in controlling Covid-19 in public health messaging. [51975/21]
View answerBuilding ventilation has remained one element of the broader infection prevention and control (IPC) response over the course of the COVID-19 pandemic. The appreciation of the role of ventilation has evolved in the context of developing experience and evidence. Guidance, training, and measures implemented reflect this learning.
The NPHET for COVID-19 regards ventilation as an important IPC measure and a NPHET subgroup, called the Expert Group on the Role of Ventilation in Reducing Transmission of COVID-19, was accordingly established in the early part of 2021 to provide scientific advice on ventilation and other control measures to reduce the risk of long-range (airborne) transmission of SARS-CoV-2.
Following the submission of the Expert Group’s second report, it was agreed that its work would be taken forward by the Senior Officials Group on COVID-19 at the Department of the Taoiseach. Since then, the Expert Group has informed Departments’ and Agencies’ work in respect of sectoral guidance and public information regarding ventilation.
It is the responsibility of individual Government departments to provide sector-specific COVID-19 advice on ventilation as per their respective remits. In this regard, the Deputy’s attention is drawn to the large volume of published guidance across a number of sectors, cited below.
In its most recent advice of 18th October, the NPHET emphasised the importance of the continuation of non-pharmaceutical interventions currently in place across sectors such as the use of face masks, improved ventilation in closed spaces and physical distancing measures until February 2022. The NPHET recommended that sector specific guidance and protocols be reviewed and strengthened where necessary.
Healthcare sector (HSE-AMRIC guidance):
“Acute Hospital Infection Prevention and Control Precautions for Possible or Confirmed COVID-19 in a Pandemic Setting V.2.5 17.08.2021” www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/guidance/infectionpreventionandcontrolguidance/
“Interim Guidance on Infection Prevention and Control for the Health Service Executive 2021 V1.3.11.01.2021” www.hpsc.ie/az/respiratory/coronavirus/novelcoronavirus/guidance/infectionpreventionandcontrolguidance/hseinfectionpreventionandcontrolguidanceandframework/Interim%20HSE%20Guidance%20on%20IPC.pdf
“COVID-19 Interim Public Health, Infection Prevention & Control Guidelines on the Prevention and Management of COVID-19 Cases and Outbreaks in Residential Care Facilities V6.7 17.08.2020”www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/guidance/infectionpreventionandcontrolguidance/
More generally, the Health Protection Surveillance Centre (HPSC) has published Guidance on non-healthcare settings: Guidance for non-clinical settings - Health Protection Surveillance Centre (hpsc.ie)
Education sector:
Education Guidance - Health Protection Surveillance Centre (hpsc.ie)
www.gov.ie/en/publication/ad236-guidance-on-ventilation-in-schools/
Workplaces, Businesses (including hospitality), Retails Settings, and Shopping Centres:
A revised Work Safely Protocol (previously the Return to Work Protocol) was published on 16th September as a collaborative effort between employers and employees, which was led by the Departments of Enterprise, Trade and Employment and Health, with the support of the Health and Safety Authority (HSA) and with significant input by public health from the Health Service Executive (HSE). The revised Protocol incorporates the current advice on the Public Health measures needed to reduce the spread of COVID-19 in the community and workplaces including enhanced detail on ventilation: www.gov.ie/en/publication/22829a-return-to-work-safely-protocol/
The Health and Safety Authority has also published checklists, including one on the topic of ventilation, to support employers preparing for the return of employees to the workplace: www.hsa.ie/eng/topics/covid-19_coronavirus_information_and_resources/
The National Standards Authority of Ireland has also published workplace shopping centre, and retail protection and improvement guides About our COVID-19 Resources | NSAI
HPSC COVID-19 has published “COVID-19 Guidance for Hospitality Businesses V1.8 01.10.2021” Hospitality guidance.pdf (hpsc.ie)
Fáilte Ireland Operational Guidelines | Business Supports | COVID-19 Support Hub | Fáilte Ireland (failteireland.ie)
Sport:
Sport Ireland has published a return to sport guidance note with information on ventilation: Return to Sport and Physical Activity | Sport Ireland
The Arts:
The Arts Council has published a guidance note for the Arts Sector: Covid - 19 Guidance for the Arts Sector (artscouncil.ie)
There is also additional guidance on Gov.ie and on the HSE website which outlines the importance of ventilation in households, this can be found here:
COVID-19 (coronavirus) - HSE.ie
www2.hse.ie/conditions/coronavirus/how-coronavirus-is-spread.html
354. Deputy Róisín Shortall asked the Minister for Health the position regarding delayed surgery for a child (details supplied) in Dublin 12; the reason for the delay; and if he will make a statement on the matter. [51976/21]
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 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. 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.
Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.
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.
