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Tuesday, 16 Nov 2021

Written Answers Nos. 507-526

Health Services

Questions (507)

Fergus O'Dowd

Question:

507. Deputy Fergus O'Dowd asked the Minister for Health if he will reply to concerns raised and proposals offered by an organisation (details supplied); and if he will make a statement on the matter. [55564/21]

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Written answers

Safeguarding adults at risk of abuse, harm and neglect by others in the context of their interactions with the health and social care sector is a key objective of the Department of Health, every statutory body under its aegis, and every relevant service that interacts with such adults. A framework of standards, policies and procedures is in place for safeguarding adults within the sector who may be at risk.

My Department is currently finalising the development of a national policy on adult safeguarding in the health and social care sector, which will apply to all public, voluntary and private healthcare and social care settings and agencies. To date, the Department, assisted by a high-level Steering Group, has completed the stakeholder consultation and primary evidence development phases of this major policy development project. The related stakeholder feedback and research publications are available on my Department’s website at www.gov.ie/en/publication/2861af-adult-safeguarding/.

My Department is preparing for public consultation and intends to submit a costed draft policy to Government for its approval in the first half of next year. Legislation as required to underpin the policy will be prepared following its approval by Government.

The Irish Association of Social Workers (IASW) has, to date, been a welcome participant in the Department’s stakeholder consultation processes on the development of this policy, which is expected to build on existing structures, including social work led specialist safeguarding services. As my Department continues to finalise this national sectoral policy, it will be pleased to receive and take account of any further concerns or proposals relating to my Department's responsibilities in this area that may be submitted by our stakeholders, including the IASW. The planned public consultation exercise will be a further opportunity for all stakeholders to continue their engagement with my Department's ongoing policy development work on adult safeguarding in the health and social care sector.

The concerns and proposals forwarded to the Deputy by the Association include some matters which extend beyond the remit of my Department. In that regard I note that the Law Reform Commission is engaged in a separate legal research initiative on A Regulatory Framework for Adult Safeguarding across all sectors. My Department has published its response to the Commission's related Issues Paper on its website at www.gov.ie/en/publication/2861af-adult-safeguarding/.

Hospital Services

Questions (508)

Matt Shanahan

Question:

508. Deputy Matt Shanahan asked the Minister for Health the reason adults attending University Hospital Waterford from County Waterford, south County Kilkenny, south County Tipperary and County Wexford for type 1 diabetes care have not had access to a diabetic nurse specialist since 4 October 2021 and are being told via an answer phone message to contact their GP or local accident and emergency department; and if he will make a statement on the matter. [55573/21]

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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 (509)

Matt Shanahan

Question:

509. Deputy Matt Shanahan asked the Minister for Health the reason University Hospital Waterford, a regional category 4 hospital with a HSE denoted patient catchment of 520,000 persons, is the only hospital in the country operating without a diabetes specialist nurse at present as the only available clinical nurse specialist has been on leave since early October 2021 without a designated replacement and with no other nursing back-up rostered to fill in; and if he will make a statement on the matter. [55574/21]

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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 (510)

Matt Shanahan

Question:

510. Deputy Matt Shanahan asked the Minister for Health regarding diabetes services at University Hospital Waterford, when the existing diabetic nurse specialist presently on call is expected back to work; the procedures in place to ensure that when a nursing specialist is on holiday leave or on extended leave the support protocol the hospital employs to cover patient queries and issues regarding ongoing treatment regime; if the hospital has a replacement policy in place to ensure key medical nurse specialists who may be the only point of contact for patient concerns have adequate trained cover provisioned within a cover plan; if that plan covers responses to medical telephone query; if such a cover plan exists, if the hospital can outline the reason it has not been implemented with the absence of the only clinical nurse specialist diabetic nurse on site who is now presently on extended leave; if the hospital sought to recruit a temporary replacement either internally or externally; if an adequate budget allocation exists for such recruitment; and if he will make a statement on the matter. [55575/21]

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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.

Vaccination Programme

Questions (511, 593, 595)

Bríd Smith

Question:

511. Deputy Bríd Smith asked the Minister for Health if flu jabs will be made available free of charge to medical card holders; if not, the reason those on low incomes will not be eligible for free vaccines especially if cost prohibits uptake when extra pressure on the health service should be avoided; and if he will make a statement on the matter. [55578/21]

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Patrick Costello

Question:

593. Deputy Patrick Costello asked the Minister for Health if provisions will be made for the flu jab to be given for free to medical card holders and the population more generally as a means to encourage uptake and reduce the strain on the intensive care unit system which is currently under strain with the ongoing Covid-19 pandemic; and if he will make a statement on the matter. [55817/21]

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Aengus Ó Snodaigh

Question:

595. Deputy Aengus Ó Snodaigh asked the Minister for Health the reason holders of full medical cards are not automatically eligible for the flu vaccine given that many of those in possession of a medical card have it on the basis of low income and therefore would find it difficult to afford the €20 to €25 cost of the flu jab in a pharmacy; and if he will make a statement on the matter. [55824/21]

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Written answers

I propose to take Questions Nos. 511, 593 and 595 together.

Prior to 2020/2021, the seasonal influenza vaccination was available without charge to Medical or GP Visit card holders in one of the HSE-defined at-risk groups. Those in the at-risk groups, who did not hold a medical card or a GP visit card were provided the vaccine without charge and typically paid an administration fee to have the vaccine administered.

In 2020/2021, given the potential for the winter influenza season to coincide with a resurgence of COVID-19 and the importance of minimising hospital attendance for the treatment of influenza, the Government expanded the provision of vaccination without charge to all of those in the at-risk groups, regardless of eligibility status, and to all children aged from 2 to 17 years.

The 2021/2022 Influenza Vaccination Programme was launched on the 4th of October 2021 and, in line with last year's expanded programme, vaccinations are available free of charge to adults in specified at-risk groups and children aged from 2 to 17 years of age. This will ensure that those most vulnerable to the effects of influenza, who are those in the at-risk groups, will have access to vaccination without charges.

By providing vaccination to those most at-risk, it is anticipated that there will be a reduction in the number of influenza-related hospital admissions, as well as a reduction in the overall spread of influenza in the community.

A person who holds a medical card or GP visit card, but who is not in one of the at-risk categories and who wishes to be vaccinated may be charged a fee.

General Practitioner Services

Questions (512)

Seán Canney

Question:

512. Deputy Seán Canney asked the Minister for Health when free general practitioner care for seven and eight year olds will come into effect; and if he will make a statement on the matter. [55584/21]

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Written answers

The Government is committed to increasing access to GP care without charges for children, 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. At present all children up to and including the age of 5 are eligible for a GP visit card and therefore GP care without charges. 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 in three phases: to children aged 6 and 7; to children aged 8 and 9; and to children aged 10,11 and 12. Budget 2022 provides for the initial stage of this phased expansion, the provision of GP care without fees to all children aged 6 and 7 and my Department has commenced work to roll this service out in the course of 2022. The specific 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 and will require consultation with the IMO, representing General Practitioners. It is important to ensure that any additional pressures placed on general practice will not limit its capacity to meet the needs of all patients in the community.

Medical Qualifications

Questions (513, 514, 515)

Matt Shanahan

Question:

513. Deputy Matt Shanahan asked the Minister for Health if he will review the current CORU processes for approving Irish citizen UK registered healthcare professionals to have their UK credentials and work experience recognised for the purposes of joining the Irish healthcare system (details supplied); if he is satisfied with the level of online support offered to applicants; if he condones a six to 12 month review process; if his attention has been drawn to the lack of personal engagement offered to applicants; if he has considered the fact that bureaucratic delays force much needed medical professionals to look for work elsewhere; the action CORU has taken to facilitate remote working in order to ensure timely and adequate responses; and if he will make a statement on the matter. [55590/21]

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Matt Shanahan

Question:

514. Deputy Matt Shanahan asked the Minister for Health if he has considered the fact that immigrant or citizen healthcare workers returning to Ireland with a view to working in the Irish healthcare system may have to wait up to 12 months to have their qualifications recognised and approved by CORU and during such time while resident in the State have no opportunity to claim jobseeker’s allowance given their work experience has been conducted in another country; if he considers this situation conducive to the recruitment of outside health expertise; if he will bring forward proposals to rectify the extreme length of CORU application approvals along with adjusted social welfare entitlements that recognise the arduous application time; and if he will make a statement on the matter. [55591/21]

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Matt Shanahan

Question:

515. Deputy Matt Shanahan asked the Minister for Health if he or his Department has information on the average length of time taken to recognise in Ireland other EU country health qualifications by CORU; if he will reference average timelines for countries such as France, Germany and Italy; if he is satisfied with the current CORU approvals process; if he will provide tabulated evidence over the past 24 months on the number of applications and their approval response times; and if he will make a statement on the matter. [55592/21]

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Written answers

I propose to take Questions Nos. 513 to 515, inclusive, together.

CORU is Ireland's multi-profession health regulator for regulating health and social care professionals. CORU’s role is to protect the public by regulating the health and social care professions designated under the Health and Social Care Professionals Act 2005 (as amended), including setting the standards that health and social care professionals must meet to be eligible to be registered and maintaining registers of persons who meet those standards There are two forms of application to CORU: applications for the recognition of qualifications received outside the State and applications for registration.

Professional qualifications awarded outside the State are assessed through a process of “recognition” which involves expert assessment of a qualification’s alignment with the standards of proficiency required in Ireland, and assessment of professional experience and lifelong learning where required. Where a health and social care professional qualifies outside the State and applies to register in Ireland, they must apply for the recognition of their qualification. EU/EEA applicants have the right to have their qualifications assessed in accordance with the Health and Social Care Professionals Act 2005, Directive 2005/36/EC on the Recognition of Professional Qualifications and the European Union (Recognition of Professional Qualifications) Regulations 2017 (SI No 8 of 2017). Once a complete file has been submitted to CORU, ie one containing all of the required documentation, a decision must issue within four months. A similar process applies to persons who have qualifications attained outside of the EU/EEA.

Data on the Number of Applications and Related Processing Times

In respect of the Deputy’s request data on the number of applications and their approval response times over the past 24 months, CORU has informed my officials that the average processing time for an application for registration is 9.2 weeks for new applicants entering a profession. This represents an improvement on an average processing time of 14 weeks, which was the case in early 2020.

Please find a table below providing data on timeframes for recognition decisions from 2016-2020.

Table A: Average number of days required to reach a recognition of qualifications decision

Country of Qualification

2016

2017

2018

2019

2020

UK incl NI

63

63

73

67

71

EU EEA

83

72

98

100

89

Rest of World

75

68

88

80

83

Total

65

65

79

74

77

Table B: Number of individual decisions made (excluding post compensation measures and European Professional Card)

Country of Qualification

2016

2017

2018

2019

2020

UK incl NI

219

336

404

343

337

EU EEA

18

46

49

39

28

Rest of World

25

116

181

246

268

Total

262

498

634

628

633

The average length of time required by equivalent bodies in France, Germany, and Italy is not available to this office.

I met with the Chairperson and CEO of CORU earlier this year and raised the issue of timeframes for the recognition of qualifications and registration applications. Following our discussion, several measures have been initiated by CORU aimed at further reducing timeframes.

Crucially, until this year, applicants were required to complete the recognition process before initiating the registration process unless they had confirmed job offers. All applicants are now invited to initiate an application for registration as soon as they have submitted a complete application file to the Recognition Department.

This is part of a suite of innovations which have been initiated following my discussions with CORU. Further steps underway as part of this programme for change include:

- Continued reorganisation of work processes to respond to the evolving working from home context (this has changed over time requiring step adjustments as the situation develops)

- Full transfer to an online application system

- Increased frequency of regulatory decision making (Registration Board meetings)

- Additional temporary staff resources

- Recruitment of additional expert assessors in ‘under pressure’ professions

In respect of the level of online support offered to applicants CORU’s reliance on email as its primary means of communication with applicants, CORU is aware of the inconvenience that this can cause applicants. Consequently, CORU is testing a new telephone system that will allow for improved engagement with applicants in the context of remote working. This Voice over IP (VoIP) solution is currently being tested for external use having been trialled internally.

My department will continue to support CORU in achieving its strategic vision and improving timeframes for all applicants into the future.

I have forwarded your query regarding a specific applicant to CORU for direct reply. Queries relating to an individual’s entitlement to an income support are a matter for the Department of Social Protection.

Question No. 514 answered with Question No. 513.
Question No. 515 answered with Question No. 513.

Hospital Staff

Questions (516)

Martin Browne

Question:

516. Deputy Martin Browne asked the Minister for Health the actions he will take to address the shortage of diabetes specialist nursing posts and dietitian posts at the University Limerick Hospitals Group; the reason for the difficulty in filling these posts; if Limerick University Hospital will be excluded from the dose adjustment for normal eating expansion given that it cannot recruit the necessary staff to undertake the educator training; and if he will make a statement on the matter. [55606/21]

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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 Waiting Lists

Questions (517)

Martin Browne

Question:

517. Deputy Martin Browne asked the Minister for Health the actions he will take to reduce the outpatient list at the diabetes clinic at the University Limerick Hospitals Group. [55607/21]

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Written answers

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.

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 National Treatment Purchase Fund (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 NTPF. The plan will be informed by the lessons learned from the successful Vaccine Taskforce.

Long-term, the Chronic Disease Management Programme, which provides GP led care for GMS patients with one of four chronic diseases including type 2 diabetes, will help reduce these patient’s reliance on related hospital services. The programme commenced in 2020, is currently available to GMS patients aged 65 and older, and will be extended to all adult GMS patients from next year.

Specific to the UL Hospital Group, funding has been made available through the national clinical programme for diabetes to recruit three additional diabetic posts for the treatment of adult diabetes and this process is at an advanced stage. The recruitment process for a staff grade dietician is also ongoing. Two further consultant endocrinology posts and four further diabetic clinical nurse specialists (CNS) posts have been approved for University Limerick Hospital. Two of the four diabetic CNS posts have been successfully recruited and are due to commence in the coming months. The additional staffing measures will have a strong positive effect on waiting times for diabetes services.

Hospital Admissions

Questions (518)

Martin Browne

Question:

518. Deputy Martin Browne asked the Minister for Health the number of patients referred to the medical assessment unit in Ennis General Hospital in each month to date in 2021. [55608/21]

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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 Admissions

Questions (519)

Martin Browne

Question:

519. Deputy Martin Browne asked the Minister for Health the number of patients referred to the medical assessment unit in St. John’s Hospital, Limerick in each month to date in 2021. [55609/21]

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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 Admissions

Questions (520)

Martin Browne

Question:

520. Deputy Martin Browne asked the Minister for Health the number of patients referred to the medical assessment unit University Hospital Limerick in each month to date in 2021. [55610/21]

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.

Hospital Appointments Status

Questions (521)

Martin Browne

Question:

521. Deputy Martin Browne asked the Minister for Health the number of appointments at the medical assessment unit in Nenagh, County Tipperary that were cancelled or referred elsewhere on the days when the unit was closed on dates in May, June, July and September 2021. [55611/21]

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.

Dental Services

Questions (522)

Denis Naughten

Question:

522. Deputy Denis Naughten asked the Minister for Health the reason the paediatric dental clinic in Mountbellew, County Galway is not operational; when it is expected it will reopen; the location in which children who would attend that clinic will now be seen; and if he will make a statement on the matter. [55628/21]

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.

Cannabis for Medicinal Use

Questions (523)

Michael Collins

Question:

523. Deputy Michael Collins asked the Minister for Health if products (details supplied) are being included in an arrangement; if not, the reason; his plans to work towards this in future; and if he will make a statement on the matter. [55631/21]

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Written answers

As the details supplied part of this Parliamentary Question relate to operational matters for the Health Service Executive (HSE), I have asked that the HSE responds to the Deputy directly regarding this part of the question.

On 27th October 2021, the Minister for Health signed legislation, Statutory Instrument 557/2021, Misuse of Drugs (Prescription and Control of Supply of Cannabis for Medical Use) (Amendment) Regulations 2021 for two further cannabis products, Oleo Bedrobinol and Oleo Bedrocan to be added to Schedule 1 of the Misuse of Drugs (Prescription and control of Supply of Cannabis for medical use) (Amendment) Regulations 2019 for use in the Medical Cannabis Access Programme. These are both dried cannabis flower-based products originating in the Netherlands. Owing to Dutch government restrictions cannabis-based oils, such as those compounded by Transvaal Apotheek in Den Haag in the Netherlands (often referred to as Bedrocan products), may not be commercially exported from the Netherlands to pharmacies or wholesalers. The commercial export of cannabis flower is permitted by the Dutch authorities.

Representations were made to the Dutch authorities about having the cannabis-based oil products exported to Ireland to facilitate Irish patients prescribed those products. The Dutch authorities replied that magistral preparations may only be provided directly to patients or their representative on the basis of a prescription, presented for dispensing.

Since April 2020, owing to the pandemic the Department has been collecting patient’s prescriptions from the Netherlands and delivering them to patient’s homes. These collections approximately every four weeks and will continue post-pandemic.

As a result of the prohibition of commercial export of the cannabis-based products the manufacturers cannot apply to the Health Products Regulatory Authority to have the products included in the Medical Cannabis Access Programme. However patient's can continue to be treated with these products if their clinicians are permitted to do so under Ministerial licence issued pursuant to the Misuse of Drugs Act 1977.

Medical Aids and Appliances

Questions (524)

Cormac Devlin

Question:

524. Deputy Cormac Devlin asked the Minister for Health the details of the authorisation of FreeStyle Libre flash glucose monitor by CHO and LHO to those patients aged under 21 and over 21 years of age, respectively in tabular form; and if he will make a statement on the matter. [55641/21]

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.

Medical Aids and Appliances

Questions (525)

Cormac Devlin

Question:

525. Deputy Cormac Devlin asked the Minister for Health the number of authorised continuous glucose monitors supplied by a company (details supplied) by CHO and LHO to patients aged under 21 and over 21, respectively, in tabular form; and if he will make a statement on the matter. [55642/21]

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.

Health Services

Questions (526, 527)

Martin Kenny

Question:

526. Deputy Martin Kenny asked the Minister for Health the number of children that are currently on the waiting list for early intervention services; the length of time they have they been on the waiting list in counties Sligo and Leitrim; and if he will make a statement on the matter. [55644/21]

View answer

Martin Kenny

Question:

527. Deputy Martin Kenny asked the Minister for Health the number of vacant positions on the early intervention teams in counties Sligo and Leitrim; and if he will make a statement on the matter. [55645/21]

View answer

Written answers

I propose to take Questions Nos. 526 and 527 together.

As these are service matters, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

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