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Tuesday, 16 Nov 2021

Written Answers Nos. 547-566

Vaccination Programme

Questions (547, 548)

Cian O'Callaghan

Question:

547. Deputy Cian O'Callaghan asked the Minister for Health when persons with underlying conditions such as type 1 diabetes will be eligible to get a Covid-19 booster vaccine; and if he will make a statement on the matter. [55702/21]

View answer

Kieran O'Donnell

Question:

548. Deputy Kieran O'Donnell asked the Minister for Health if he will provide an update on the scheduling of booster vaccines for persons with diabetes; and if he will make a statement on the matter. [55708/21]

View answer

Written answers

I propose to take Questions Nos. 547 and 548 together.

The immunisation programme in Ireland is based on the advice of the National Immunisation Advisory Committee (NIAC). The NIAC makes recommendations on vaccination policy to my Department based on the prevalence of the relevant disease in Ireland and international best practices in relation to immunisation.

More than 7.6 million doses of COVID-19 vaccine have now been administered since the programme began in December last year. As the first phase of vaccination nears completion, the NIAC has been examining evidence regarding booster vaccines.

The NIAC has recommended that a booster dose of an mRNA vaccine (irrespective of whether the primary vaccination course was of an mRNA or adenoviral vector) be offered to those aged 60 years and older and healthcare workers. The booster dose should be given after an interval of six months (or at least five months) following the last dose of any authorised COVID-19 vaccine. I have accepted this advice and the HSE has made the necessary arrangements to operationalise these recommendations with the booster rollout now underway.

The NIAC has also recommended an additional mRNA dose should be given to those aged 12 years and older with immunocompromise associated with a suboptimal response to vaccination who have completed their primary vaccination course. The third dose of an mRNA vaccine should be given a minimum of two months after the last dose of the primary vaccination schedule.

You can view the NIAC recommendations regarding those with immunocompromise associated with a suboptimal response at the below link. rcpi-live-cdn.s3.amazonaws.com/wp-content/uploads/2021/09/Recommendations-re-additional-COVID-19-vaccine-dose-for-those-with-Immunocompromise-FINAL-30082021.pdf

The NIAC continues to examine emerging evidence regarding booster vaccines for those with waning immunity and reduced effectiveness in other groups, such as those with co-morbidities (under 60 years of age) and will make further recommendations if required.

Question No. 548 answered with Question No. 547.

Primary Care Centres

Questions (549)

Pádraig O'Sullivan

Question:

549. Deputy Pádraig O'Sullivan asked the Minister for Health if he will provide an update on the planned development and refurbishment of the former Monasterevin day care centre as a health care centre including the timeframes for completion; and if he will make a statement on the matter. [55710/21]

View answer

Written answers

Work is continuing on the preparation of tender documents for this project and all statutory approvals including, Planning Permission, the Fire Safety Certificate (FSC) and Disability Access Certificate (DAC) have been received. Tender documents are expected to issue in Q1 2022, followed by an 18-month construction programme with completion anticipated for 2023. Once it is finished the day care centre will be a permanent location for both an Older Persons Day Service and a Primary Care Service in the town of Monasterevin.

All capital development proposals must progress through a number of approval stages, in line with the Public Spending Code, including detailed appraisal, planning, design and procurement before a firm timeline or funding requirement can be established.

The delivery of capital projects is a dynamic process and is subject to the successful completion of the various approval stages. The final decision to proceed with the construction of a project cannot be made until the tender process has been completed and the costings reviewed to ensure that the proposal delivers value for money and remains affordable, and that sufficient funding is available to fund the project to completion, including equipping and commissioning costs.

Covid-19 Tests

Questions (550)

Catherine Connolly

Question:

550. Deputy Catherine Connolly asked the Minister for Health his plans to open an additional Covid-19 test centre in Galway which would be located in the city centre and would operate seven days a week in order to facilitate increased and more timely testing for Covid-19; and if he will make a statement on the matter. [55716/21]

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.

Abortion Services

Questions (551)

Paul Murphy

Question:

551. Deputy Paul Murphy asked the Minister for Health if he will provide the dates of termination of pregnancy services carried out in Limerick Maternity Hospital in the past two months. [55717/21]

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Written answers

Under section 20 (1) of the Health (Regulation of Termination of Pregnancy) Act 2018, a notification of each termination of pregnancy carried out under the legislation must be notified to the Minister for Health within 28 days of it being carried out.

The notifications are recorded on the form entitled “Health (Regulation of Termination of Pregnancy) Act 2018 (Notifications) Regulations 2018” (Statutory Instrument No. 597 of 2018). The following information is included in the form:

- Medical Council registration number of the medical practitioner who carried out the termination of pregnancy;

- The section of the Act under which the termination was carried out, i.e., section 9, 10, 11 or 12;

- Medical Council registration number(s) of the medical practitioner(s) who made the certification concerned;

- The county of residence, or place of residence (where the woman resides outside of the State) of the woman concerned;

- The date on which the termination of pregnancy was carried out.

No other information is notified to the Minister. This includes information on the number of terminations of pregnancy carried out by each hospital providing the service in a given time period.

The Health (Regulation of Termination of Pregnancy) Act 2018 - Annual Report on Notifications 2020 was published on 29 June 2021, and is available on the Department of Health website.

Disability Services

Questions (552)

Mark Ward

Question:

552. Deputy Mark Ward asked the Minister for Health if he will provide an update on progressing disability teams; the services they provide; the number of persons on each waiting list by service by CHO area in tabular form; and if he will make a statement on the matter. [55718/21]

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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.

Disability Services

Questions (553)

Mark Ward

Question:

553. Deputy Mark Ward asked the Minister for Health if the post of manger for the disability team CDNT 4 in a location (details supplied) has been filled; the length of time this position has or had been vacant; and if he will make a statement on the matter. [55719/21]

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.

Disability Services

Questions (554)

Mark Ward

Question:

554. Deputy Mark Ward asked the Minister for Health if the post for interim manager CDNT 4 Central Remedial Clinic in Clondalkin has been filled; the length of time this position has or had been vacant; and if he will make a statement on the matter. [55720/21]

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 Staff

Questions (555)

Michael Moynihan

Question:

555. Deputy Michael Moynihan asked the Minister for Health the action that is being taken to increase the number of neurology nurse specialists at Cork University Hospital; if an additional 100 extra neurology nurse specialists will be provided across Ireland; and if he will make a statement on the matter. [55725/21]

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.

Medicinal Products

Questions (556)

Alan Kelly

Question:

556. Deputy Alan Kelly asked the Minister for Health when the drug Epidiolex will be available on the drug reimbursement scheme; and if he will make a statement on the matter. [55728/21]

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Written answers

The HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drug schemes, in accordance with the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013; therefore, the matter has been referred to the HSE for reply to the Deputy.

Departmental Meetings

Questions (557)

Paul Murphy

Question:

557. Deputy Paul Murphy asked the Minister for Health if his attention has been drawn to an organisation (details supplied); if he will meet with those working with same; and if he will make a statement on the matter. [55733/21]

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Written answers

There are a range of services in place to protect individuals and families from excessive costs for their medical and surgical needs.

The Health Service Executive (HSE) provides a wide range of medical and surgical aids and appliances free of charge to eligible persons following assessment by a relevant health professional. These aids and appliances are provided by the HSE through community services known as Community Funded Schemes. Each application within a Community Health Organisation for eligible persons is assessed by the local Resource Allocation Group and a determination is made regarding approval based on priority and the funding available. At times, due to the demand for resources exceeding the available capacity, waiting lists may apply for some categories of items provided through the medical and surgical aids and appliances budget in a particular Community Health Organisation. A HSE Primary Care led National Service Improvement Programme has the aim of improving the equity of access, value for money, and functional processes of the Community Funded Schemes through the establishment of national guidelines for the provision of medical and surgical aids and appliances. As the situation involving the Covid-19 pandemic improves, this Programme will gather pace.

The Long Term Illness Scheme, established under Section 59(3) of the Health Act 1970 (as amended), allows patients to receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge. 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 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. Further information regarding these schemes is available at www2.hse.ie/costs-schemes-allowances/

Individuals may also be entitled to claim tax relief on the cost of medical expenses. This includes medicines prescribed by a doctor, dentist, or consultant. Relief is at the standard tax rate of 20%. Details on how to claim are at www.revenue.ie.

The HSE has statutory responsibility for decisions on pricing and reimbursement of medicines under the community drugs schemes, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013. Reimbursement for medicines under the community drugs schemes is for licenced indications which have been granted market authorisation by the European Medicines Agency or the Health Products Regulatory Authority (HPRA) in Ireland. In making a relevant reimbursement decision, the HSE is required under the Act to have regard to a number of criteria including efficacy, the health needs of the public, cost effectiveness and potential or actual budget impact.

In May 2019 the drug Ataluren (Translarna®) indicated for the treatment of Duchenne muscular dystrophy resulting from a nonsense mutation in the dystrophin gene, in ambulatory patients aged 5 and older was approved by the HPRA under the high tech arrangement and is therefore included in the listing of reimbursable items. It is important to note that the medical decision to prescribe or not prescribe any treatment, for an individual patient is strictly a decision for the treating clinician, in consultation with their patient. I, as the Minister for Health, have no role in this clinical decision-making process and 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.

Finally, while I make every effort to meet with as many stakeholders as possible, it is not always possible to commit to every meeting request. However, it is a normal and productive practice for my officials to meet with interest groups on my behalf and I would suggest that the organisation in question submit a formal meeting request to my office.

Nursing Homes

Questions (558)

Gino Kenny

Question:

558. Deputy Gino Kenny asked the Minister for Health the impact the new legislation enacted recently will have on a fair deal scheme applicant who has been approved for the scheme but before they take up a bed in a nursing home their main primary residence is sold by their spouse; if the proceeds from the sale of the primary residence is not considered cash assets but rather is determined in a similar way as prior to the sale and the fair deal contribution will be capped at 7.5% of the value of the house for three years; and if he will make a statement on the matter. [55734/21]

View answer

Written answers

The Nursing Home Support Scheme (NHSS), commonly referred to as 'Fair Deal', is a system of financial support for people who require long-term residential care. The primary legislation underpinning the NHSS is the Nursing Home Support Scheme Act 2009. Participants in the NHSS contribute to the cost of their care according to their means while the State pays the balance of the cost. The Scheme aims to ensure that long-term nursing home care is accessible and affordable for everyone, and that people are cared for in the most appropriate settings.

Within the NHSS, the asset value of a resident's home, known in the Scheme as the "principal residence", is assessed for 3 years, with 7.5% of its value going towards the cost of care (3.75% in the case of a couple). After 3 years on the scheme, the value of this property is no longer assessed. In practice, this generally reduces the nursing home fees of those maintaining their home, from year four onwards. However, under previous rules, if it was sold, the resulting cash asset was assessable in full for the entire length of stay in care. This could act as a disincentive for those who might otherwise consider selling their homes. The 2021 Act now extends the 3-year cap to cover the proceeds of sale, so that a person will be able to sell their home without incurring additional fees from the fourth year onwards.

Under Schedule 1, Part 3, Section 10C of the Nursing Homes Support Scheme Act 2009 as amended, the 3-year cap on the proceeds of sale only applies where the sale takes place after the person in care begins receiving long-term residential care services or transitional care services.

Mental Health Services

Questions (559)

Mark Ward

Question:

559. Deputy Mark Ward asked the Minister for Health the number of liaison psychiatry hospital teams; the location of each team; the number of staff per team; if they are operating at full staff capacity; and if he will make a statement on the matter. [55736/21]

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.

Mental Health Services

Questions (560)

Mark Ward

Question:

560. Deputy Mark Ward asked the Minister for Health his plans to develop an outpatient national advocacy service for mental health; the estimated cost of establishing an outpatient national advocacy service for mental health; and if he will make a statement on the matter. [55737/21]

View answer

Written answers

The Department and HSE National Mental Health Services are fully committed to ensuring that people using our mental health services have all necessary supports and that their voices are heard when decisions are being made about their treatment.

Recommendation 92 of our national mental health policy, Sharing the Vision, states that “a range of advocacy supports including both peer and representative advocacy should be available as a right for all individuals involved with the mental health services”.

As the Deputy will be aware, a General Scheme to amend the Mental Health Act 2001 was approved by Government on 13 July 2021. The General Scheme is primarily based on the 165 recommendations of a 2015 Expert Group Review of the Act, as well as the results of a 2021 public consultation, extensive consultation with key stakeholders such as the Mental Health Commission and HSE. The General Scheme takes account of domestic legislative changes, including the Assisted Decision-Making (Capacity) Act 2015 and the Mental Health (Amendment) Act 2018, and Ireland’s international obligations, including the UN Convention on the Rights of Persons with Disabilities, the UN Convention on the Rights of the Child and European Convention on Human Rights.

The Department of Health will work with the Office of the Attorney General to prepare the final Bill in line with the General Scheme. Pre-legislative scrutiny of the Bill by the Sub-Committee on Mental Health commenced on 2nd November 2021.

The Department has included a statutory right to engage an advocate under numerous heads of the General Scheme, including a definition of advocate under Section 2, information on advocacy to be provided to people in approved inpatient facilities under Section 16, 79 and 91, access to an advocate during a review board under Section 16B, during inquiries carried out by the Inspector under Section 55, or when making decisions about treatment under Sections 56 and 104.

The HSE currently provides some advocacy supports, including a Peer Advocacy Service in mental health which costs approximately €800,000 per annum. This service is concentrated on inpatient services and is delivered by an external agency on behalf of the HSE.

The HSE has estimated that the cost of extending a minimal advocacy service to all adult mental health community services, as well as inpatient units, would cost in the region of an additional €600,000, depending on the model used.

In addition to adult advocacy services, HSE National Mental Health Services currently provide an advocacy service through an external provider for young people and their families using Child and Adolescent Mental Health Services (CAMHS). Currently the CAMHS advocacy service is provided in two of our inpatient units at a cost of €80,000 per annum. This cost also covers some community advocacy in CHO2. To provide a baseline national CAMHS Advocacy service for both inpatient and community child and adolescent mental health services would cost approximately €240,000 per annum.

Therefore, based on the above, the full estimated cost of providing a National Advocacy Service for both adult and child mental health services would be in the region of €1.64 million per annum. It is important to note that this is a broad estimate and all expanded or new services would be subject to current contract arrangements, procurement rules and HSE National Financial Regulations.

The National Advocacy Service for People with Disabilities (NAS) provides a free, confidential service to people with mental health difficulties, particularly people with complex needs. NAS is funded and supported by the Citizens Information Board, which has a mandate under the Citizens Information Act 2007 and the Comhairle Act 2000 to provide advocacy for persons with disabilities.

Sage Advocacy also provides some advocacy support to people with mental health difficulties, particularly older people, in their role in supporting and enabling vulnerable adults and older people to make their voices heard in their healthcare decisions.

Access to advocacy supports forms part of Sharing the Vision, our national mental health policy, and the right to consult an advocate will be included in the updated Mental Health Act. While advocacy supports are currently available through the HSE and other actors, such as Sage Advocacy and the NAS, the Department recognises that services will need to expand in order to reach all people accessing mental health services, be that on an inpatient or outpatient basis. Discussions on how advocacy supports for people accessing outpatient mental health services will continue in the context of the implementation of Sharing the Vision.

Mental Health Services

Questions (561)

Mark Ward

Question:

561. Deputy Mark Ward asked the Minister for Health the breakdown of the €7.65 million of revenue funding and €6 million of once-off funding allocated to purchasing additional capacity for mental health services; the amount spent to date; the breakdown of services provided; and if he will make a statement on the matter. [55738/21]

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.

Abortion Services

Questions (562, 612, 630)

Carol Nolan

Question:

562. Deputy Carol Nolan asked the Minister for Health if he will commit to fulfilling the three year review of abortion legislation by 1 January 2022 as set out under section 7 of the Health (Regulation of Termination of Pregnancy) Act 2018; the length of time he plans to leave open the period of public consultation during this process; his views on whether this period will be sufficient time to receive and reflect upon submissions adequately before the full report is submitted; and if he will make a statement on the matter. [55745/21]

View answer

Holly Cairns

Question:

612. Deputy Holly Cairns asked the Minister for Health the details of the review of the Health (Regulation of Termination of Pregnancy) Act 2018 which is due to take not later than three years after its commencement under section 7 of the Act; the format the review will take; and if he will make a statement on the matter. [55958/21]

View answer

Bríd Smith

Question:

630. Deputy Bríd Smith asked the Minister for Health the person appointed as the independent expert to lead the abortion legislation review; when consultation with service users and providers will begin; when public consultation will begin; if the review will be completed by 1 January 2022 as per section 7 of the Health (Regulation of Termination of Pregnancy) Act 2018; and if he will make a statement on the matter. [56032/21]

View answer

Written answers

I propose to take Questions Nos. 562, 612 and 630 together.

The Health (Regulation of Termination of Pregnancy) Act 2018 was signed into law on 20 December 2018 and commenced on 1 January 2019. Under the section 7 of Act, a review of the operation of the Act must be initiated within three years of the commencement of the Act, i.e., before January 2022.

The review of the operation of the Act is being progressed this year, in line with statutory and Government commitments, and will conclude in 2022.

The Minister has previously stated that an independent Chair will be appointed to lead the review, which will comprise a three-part approach to appraise the operation of the Act, with strands focusing on service users, service providers and a public consultation. Independent research commissioned to inform the service user and service provider strands will form key elements of the review. An opportunity will be provided for interested groups, organisations and members of the public to provide their views to inform the review.

Upon completion of the review, a full report with any necessary recommendations, will be submitted to the Minister for consideration

Self-Harm Prevention

Questions (563, 564, 565, 566, 567)

Catherine Murphy

Question:

563. Deputy Catherine Murphy asked the Minister for Health the counties in which the HSE operates its Self-Harm Intervention Programme. [55757/21]

View answer

Catherine Murphy

Question:

564. Deputy Catherine Murphy asked the Minister for Health the number of staff employed by the HSE nationally to deliver the Self-Harm Intervention Programme. [55758/21]

View answer

Catherine Murphy

Question:

565. Deputy Catherine Murphy asked the Minister for Health the number of referrals in each CHO to the Self-Harm Intervention Programme in 2019, 2020 and to date in 2021. [55759/21]

View answer

Catherine Murphy

Question:

566. Deputy Catherine Murphy asked the Minister for Health the total operational costs associated with the HSE Self-Harm Intervention Programme in 2019, 2020 and to date in 2021, including the cost per treatment session. [55760/21]

View answer

Catherine Murphy

Question:

567. Deputy Catherine Murphy asked the Minister for Health the breakdown of waiting times in each CHO for the Self-Harm Intervention Programme in 2019, 2020 and to date in 2021. [55761/21]

View answer

Written answers

I propose to take Questions Nos. 563 to 567, inclusive, together.

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

Question No. 564 answered with Question No. 563.
Question No. 565 answered with Question No. 563.
Question No. 566 answered with Question No. 563.
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