Written Answers Nos. 680-702
680. Deputy David Cullinane asked the Minister for Health the number of community hospital beds in the Saolta Group counties available to patients on discharge from acute hospitals; if he plans to increase community bed capacity; and if he will make a statement on the matter. [58952/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
681. Deputy Ivana Bacik asked the Minister for Health the length of time persons who have been assessed for delivery of home support hours must wait for a carer to become available; and the number of the 4,933 persons in this category as at end September 2021 that have been waiting in excess of one, three, six months and one year, respectively in tabular form. [58954/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
682. Deputy Colm Burke asked the Minister for Health if the Government has recognised the high levels of post-traumatic stress, mood disturbance and moral injury that an organisation (details supplied) has identified amongst nursing home staff during the Covid-19 pandemic and which need to be incorporated into planning supports for this workforce; and if he will make a statement on the matter. [58958/21]
View answer684. Deputy Colm Burke asked the Minister for Health the level of funding that has been provided to help deliver employee assistance programmes or other counselling programmes to the nursing home staff that are dealing with post traumatic effects of the Covid-19 emergency; and if he will make a statement on the matter. [58960/21]
View answerI propose to take Questions Nos. 682 and 684 together.
Nursing home providers, like any other employer, have a duty to ensure employees’ safety, health and welfare at work, as far as reasonably practicable. The Safety, Health and Welfare at Work Act 2005, requires employers to put in place systems of work which protect employees from hazards which could lead to mental or physical ill-health. There is an obligation on employers to risk assess all known hazards including psychosocial hazards, which might lead to stress.
In response to the current COVID-19 crisis the HSE is co-ordinating a comprehensive psychosocial response to address the overall emergency and its impact into the future. Further details can be found here www.hse.ie/eng/services/list/4/mental-health-services/psychosocial-response-group/
Each local CHO area offers a number of key supports:
- A Psychological First Aid Call Back Service - for health care workers and some targeted groups of the public, who may be feeling stressed or anxious about the impact of COVID-19
- Trained psychosocial responders will provide a brief telephone contact to help callers to cope with the daily challenges at this time.
- Psychological First Aid Informed Briefings for Healthcare Workers have also been developed and are available on HSELanD, the HSE’s training and development portal.
In addition, in line with the COVID-19 Nursing Homes Expert Panel recommendations, I was pleased to announce as part of Budget 2022 that funding is being made available to the HSE to undertake a further once-off programme in 2022 to provide enhanced psychological supports to nursing home residents, families and staff. Each nursing home will be offered an opportunity to participate. Department officials are engaged with the HSE on the roll-out of this intervention over the coming months and further detailed planning will be undertaken following the completion of the 2022 National Service Planning process.
For private and voluntary nursing homes, the Temporary Assistance Payment Scheme (TAPS) was established in April 2020 as a temporary administrative measure in response to the challenges faced by the nursing home sector at the start of the pandemic. As of 24 November, over 8,172 claims had been processed as part of the Scheme, reimbursing nursing homes for a broad range of expenses incurred as a result of the pandemic, including measures aimed at the workforce such as training and other supports. In total, €134.5 million has been made available under TAPS between 2020 and 2021.
While the standard assistance element of the scheme ceased at the end of June 2021 having already been extended twice, TAPS has broadly fulfilled its temporary purpose of providing financial support to nursing homes to address COVID-19. Although the risk is greatly reduced, it has not been completely eliminated, therefore the outbreak assistance element of the Scheme will continue to be available to nursing homes until the end of 2021.
As the pandemic has continued, many further support measures for private and voluntary nursing homes have been made available through the Health Service Executive (HSE), including the provision of PPE on a no-cost basis, the implementation of serial testing, the support and engagement of COVID-19 response teams and public health teams, the temporary accommodation scheme for nursing home staff and further supports. Many of these supports will continue to be provided by the HSE for the foreseeable future.
As the Deputy may be aware, the Department is currently conducting the first part of Phase 3 of the Safe Nurse and Skill Mix Framework (SSF). Phase 3 (a) will develop an evidence-based approach to determining the staffing and skill mix required in a long-term residential care setting. Staffing levels determined by the SSF are directed and implemented based on evidence from patient / resident outcomes as the key indicator of the staffing adjustment needed. This flexibility has proven successful in the previous two phases of the SSF. The National Taskforce for Phase 3 of the SSF commenced in February 2021 and has undertaken a review of the available international evidence and selected a model for further testing. Following an open call, nine pilot sites have been chosen from across the country to test the model identified. Baseline data collection in the pilot sites will start imminently, once local governance structures are in place, with staffing adjustments expected to be made in the pilot sites in Q1 2022. Based on the evidence Phase 3 (a) will, in line with other phases, be developed into a national policy for broader implementation. This flexible, evidence-based approach to nurse staffing and skill mix will enable informed staffing levels based on patient / resident need across the variety of nursing home / residential care settings in Ireland.
I am committed to establishing a Cross Departmental Strategic Workforce Advisory Group. The role of the group will be to facilitate the views of stakeholders and examine workforce challenges in home support and nursing homes. Potential areas to be considered include recruitment, retention, training, career development, and the sustainable employment of home care workers and nursing home workers into the future.
I have referred the Deputy's questions to the HSE and have asked the Executive to advise him of the relevant operational supports it is providing, internally and to the sector.
683. Deputy Colm Burke asked the Minister for Health the actions his Department is taking to ensure gerontological care within nursing homes and beyond is appropriately resourced and valued by the State; and if he will make a statement on the matter. [58959/21]
View answerThe 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 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.
A comprehensive review of the operation of the Nursing Homes Support Scheme (NHSS) identified the need to undertake a review of the pricing mechanism used by the NTPF. The Minister for Health subsequently requested that the NTPF carry out a review of the pricing system. A steering group was established with representation from various departments and agencies and expert advice and stakeholder submissions were sought. The terms of this review were to:
- Ensure value for money and economy, with the lowest possible administrative costs for clients and the State and administrative burden for providers;
- Increase the transparency of the pricing mechanism so that existing and potential investors can make as informed decisions as possible; and
- Ensure that there is adequate residential capacity for those residents with more complex needs.
Both Minister Donnelly and I have considered the review, agreed to the recommendations within, and have requested that the Department and NTPF move forward with delivery of the recommendations that they are responsible for. This review is published on Department's website.
The Safe Staffing Framework is an evidence-based methodology to determine the required nursing workforce based on patient acuity and dependency. The Framework was launched by Minister Harris, on 16 April 2018, on publication of the Final Report and Recommendations of the Taskforce on Staffing and Skill Mix for Nursing, on a Framework for Safe Nurse Staffing and Skill Mix in General and Specialist Medical and Surgical Care Settings in Adult Hospitals (www.gov.ie/en/publication/2d1198-framework-for-safe-nurse-staffing-and-skill-mix-in-general-and-speci/). To date there have been three phases of the Safe Staffing Framework Development, Phase 3 being the Framework for Safe Nurse Staffing in Community settings, including (a) Long-Term residential care settings for older persons, (b) Community care settings, and (c) Step-down and Rehabilitation settings.
As the Deputy may be aware, the Department is currently conducting the first part of Phase 3 of the Safe Nurse and Skill Mix Framework (SSF). Phase 3 (a) will develop an evidence-based approach to determining the staffing and skill mix required in a long-term residential care setting. Staffing levels determined by the SSF are directed and implemented based on evidence from patient / resident outcomes as the key indicator of the staffing adjustment needed. This flexibility has proven successful in the previous two phases of the SSF.
The National Taskforce for Phase 3 of the SSF commenced in February 2021 and has undertaken a review of the available international evidence and selected a model for further testing. Following an open call, nine pilot sites have been chosen from across the country to test the model identified. Baseline data collection in the pilot sites will start imminently, once local governance structures are in place, with staffing adjustments expected to be made in the pilot sites in Q1 2022. Based on the evidence Phase 3 (a) will, in line with other phases, be developed into a national policy for broader implementation. This flexible, evidence-based approach to nurse staffing and skill mix will enable informed staffing levels based on patient / resident need across the variety of nursing home / residential care settings in Ireland.
685. Deputy Colm Burke asked the Minister for Health the actions taken to acknowledge the gravity of the strain that has been placed upon staff in nursing homes and the broader health services throughout the Covid-19 pandemic; and if he will make a statement on the matter. [58961/21]
View answerBoth I and my Department recognise that our dedicated health care workers play a key role in our national effort against Covid-19. The determination and commitment of staff delivering our health services in assisting our sick and vulnerable to get the medical treatment they need, has and continues to be, very much appreciated.
Supports are available to staff of the public health service, which can be accessed via the HSE's occupational health service. I have asked the HSE to respond to the Deputy directly in relation to those supports available.
In addition to this, the provision of additional funding in Budget 2021 and Budget 2022 is allowing for the continued growth of the health sector workforce as a means to assist in the management of the pandemic. In 2021, year-to-date the workforce has grown by 4,952 WTE which is the second largest annual growth since the formation of the HSE, second only to growth achieved in 2020.
It is noted that the Government intends to recognise front-line healthcare workers in respect of the extraordinary contribution and commitment they have made in the management of the pandemic. Government are considering the most appropriate means and timeline for such recognition, noting that the pandemic is ongoing.
686. Deputy Colm Burke asked the Minister for Health the appropriate supports the Government plans to bring into effect to support staff in nursing homes and the broader health services in living with the lasting effects of Covid-19; and if he will make a statement on the matter. [58962/21]
View answerI have asked the HSE to respond to the Deputy in respect of supports for employees throughout the public health service.
687. Deputy Dara Calleary asked the Minister for Health the timeline and the process for the proposed review of the Health (Regulation of Termination of Pregnancy) Act 2018; the proposed methods for public input; and if he will make a statement on the matter. [58963/21]
View answer689. Deputy David Cullinane asked the Minister for Health when he will publish the terms of reference of the review of the Health (Regulation of Termination of Pregnancy) Act 2018; when he will announce the appointment of a lead independent expert; when each of the strands of the review will begin; and if he will make a statement on the matter. [58975/21]
View answerI propose to take Questions Nos. 687 and 689 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.
As I have stated previously, 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.
688. Deputy Claire Kerrane asked the Minister for Health the funding streams available for research purposes that could be accessed by a PhD student in research concerning children with intellectual disabilities and autism in tabular form. [58970/21]
View answerThe Health Research Board (HRB) is the largest funder of health research in the state. The HRB is committed to training, supporting and developing academic researchers and health and care practitioners along the journey from doctoral training to research leadership. There are two separate research career pathways; each one is underpinned by a specific set of funding schemes.
1. Health and care practitioners (This refers to anyone providing clinical care including medics, allied health professionals, dentists, nurses and midwives.). Doctoral training is through the ICAT Scheme and Collaborative Doctoral Awards www.hrb.ie/funding/funding-schemes/health-research-career-paths/health-and-care-practitioners/
2. Academic researchers. The research career path for academic researchers aims to support and develop people along the journey from doctoral training to research leadership. Doctoral training is through the Structured Population and Health-services Research Education (SPHeRE) PhD Scholars Programme and Collaborative Doctoral Awards: www.hrb.ie/funding/funding-schemes/health-research-career-paths/academic-researchers/
Please note that these are PhD structured programme and not individual scholarships. Recruitment of PhD students is done through the funded programmes, not directly by the HRB, to match the focus of the programme.
Individual project and program grants may also recruit PhD students, although this is not their primary focus. In terms of the specific interests of the PQ, the program that is the closest in interest, and which is currently being renewed for a further phase of activity is IDS-TILDA (Intellectual Disability Supplement to TILDA, the national Longitudinal Study on Ageing). However, this program is focused on adults with ID, as opposed to children.
The Irish Research Council, through its Government of Ireland Postgraduate Scholarship Programme (research.ie/funding/goipg/?f=postgraduate) supports individual awards for excellent research in the name of the applicant. This scheme funds across all disciplines, from archaeology to zoology and awards are for bottom-up, non-directed research.
690. Deputy David Cullinane asked the Minister for Health if he has or will adjust the recruitment process for permanent and locum doctors, nursing, health care assistants and other posts in the health service; if the HSE will or has devolved power to hospital management or group management or otherwise senior staff below a national level; and if he will make a statement on the matter. [58976/21]
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
691. Deputy David Cullinane asked the Minister for Health if his attention has been drawn to issues regarding international recruitment into the health service regarding work permits; if his attention has been further drawn to issues regarding the recruitment of carers and healthcare assistants and disputes regarding constraints on critical skills employment permits; his plans to address the shortage of carers and healthcare assistants; and if he will make a statement on the matter. [58977/21]
View answerCOVID-19 brought a range of challenges to our health service and our health service workforce. To continue to meet the ongoing demands caused by the pandemic, as well as to provide necessary resources for the longer-term health care requirements of our population, the health sector workforce is expanding. There are significant recruitment campaigns, both in Ireland and Internationally ongoing across all Hospital Groups on a continuous basis.
The Government is committed to funding the provision of healthcare in order to deliver services in line with Sláintecare objectives. This is underpinned by the provision of funding in Budget 2022 which allows for the continued growth of the health sector workforce up to an estimated 141,491 WTE in 2022. This would be a further increase of 10,855 WTE from the current numbers equating to an increase of 8%.
My Department engages on an ongoing basis with the HSE, the Interdepartmental Group for Economic Migration Policy and other Government Departments regarding employment permits and the operation of the Critical Skills and Ineligible Occupations Lists.
The employment permits system operated by the Department of Enterprise Trade and Employment is designed to facilitate the entry of appropriately skilled non-EEA nationals to fill skills and or labour shortages. The system is managed through the operation of the Critical Skills and Ineligible Occupations Lists, which determine employments that are either in high demand or are ineligible for an employment permit, where there is a surplus of those skills in the domestic and EEA labour market.
The Critical Skills and Ineligible Occupations Lists are subject to twice-yearly review which is predicated on a formalised and evidence-based process which involves consideration of the research undertaken by the Skills and Labour Market Research Unit (Solas), the Expert Group of Future Skills Needs (EGFSN), the National Skills Council, and input by relevant Government Departments in addition to the public consultation phase.
As part of the most recent review of the occupations lists, officials from my Department engaged in discussions with officials from the Department of Enterprise Trade and Employment in respect of submissions received relating to the health sector. The submissions received from the home care sector were considered by the Department of Health, Department of Enterprise Trade and Employment and the Interdepartmental Group for Economic Migration Policy.
The review did not recommend removal of the occupation of care worker/home carers from the Ineligible Occupations List as the evidence suggested that contracts of employment and terms and conditions being offered are significant factors in the recruitment challenges faced by the sector, rather than a demonstrable labour market shortage. To have an occupation removed from the ineligible list, there needs to be a clear demonstration that recruitment difficulties are solely due to skills and labour shortages in Ireland and the EEA and not to other factors such as salary and or employment conditions.
It was not considered appropriate to make any changes to the eligibility for employment permits for home carers on this occasion as there was insufficient evidence that the issue is not one of terms and conditions. A longer-term approach is required to address these challenges and the Department of Health is committed to working with relevant stakeholders to seek to address these issues.
My colleague the Minister for Mental Health and Older People has committed to establishing a Cross Departmental Strategic Workforce Advisory Group. The role of the group will be to facilitate the views of stakeholders and examine the evidence regarding the skills and labour market shortage, in home support and nursing homes. Potential areas to be considered include recruitment, retention, skills development, and sustainable employment of home carers into the future. Part of the work of this group will involve engagement with the relevant stakeholders in the sector.
692. Deputy David Cullinane asked the Minister for Health his plans to address the severe overtime culture in the HSE; the average number of overtime hours worked on a weekly basis by grade within the medical, dental, nursing and midwifery and healthcare assistant professions in acute hospitals; his plans to ensure that promise overtime rates are applied in every hospital; and if he will make a statement on the matter. [58978/21]
View answerThe Government is committed to funding the provision of healthcare in order to deliver services in line with Sláintecare objectives. This is underpinned by the provision of funding in Budget 2021 and Budget 2022 which have allowed for the continued growth of the health sector workforce.
To date this year the workforce has grown by 4,952 WTE which is the second largest annual growth since the formation of the HSE, second only to growth achieved in 2020. This level of growth should assist health service managers in reducing the levels of reliance on overtime.
My Department issued DoH Circular 12/2021 on the 2nd July in respect of adjustments to overtime rates. I have asked the HSE to respond to the Deputy in respect of the application of this circular to employees throughout the health service as appropriate, as well as in respect of hours worked.
693. Deputy David Cullinane asked the Minister for Health his plans to expand menopause supports and awareness; the steps he has taken since becoming Minister; his plans for the future; and if he will make a statement on the matter. [58979/21]
View answerThe Government recognises that menopause is a key health issue for women in Ireland today, and work is underway to drive progress in this area which is being driven by the Women’s Health Taskforce. The Taskforce was convened in September 2019, to improve health outcomes and health experiences for women and girls.Significant activity is currently underway to enhance the supports available to women through the menopause. Minister Donnelly announced his commitment to establish dedicated specialist menopause clinics across Ireland on the 10th of September. These clinics will form a core part of a new approach to menopause care for women in Ireland and will be supported by enhanced community and primary care supports as well as the publication of targeted and trusted sources of information for women experiencing menopause.
The first phase of change will include the development of a dedicated specialist menopause clinic, in the National Maternity Hospital, Holles Street this year. The clinic will be multidisciplinary supported by GPs with a certified special interest in the area of menopause and clinical nurse/midwife specialists. In addition to seeing women who meet the clinical criteria for referral to the service, the clinical team will also provide advice and guidance to GPs in the community to support the effective management of menopausal symptoms for women closer to home within primary care. Further details on this announcement can be found here:www.gov.ie/en/press-release/bf7d4-minister-for-health-announces-a-new-approach-to-menopause-care-for-women-in-ireland/
Funding for a further three specialist menopause clinics were announced within Budget 2022.
Additional activity underway and planned in the area of menopause includes:
- GP training is a key aspect of women receiving the best care through menopause. The Irish College of GPs are active members of the Women's Health Taskforce and continue to be engaged on how women's health can be better considered within the primary care setting. Relevant activity includes the collaboration between ICGP and the British Menopause Society to develop training in menopause management, which is currently in place; a recent ICGP Women’s Health Webinar on menopause and endometriosis which was held in June 2021 and had 1567 attendees; and a GP Education course which was established in September 2021 in the area of Community Gynaecology Course which includes menopause as a topic. Funding has been provided through the Women's Health Fund to develop a 'quick reference guide' for GPs on the menopause, to support primary care provision in this area. The Minister has outlined his support for a new ICGP post of Clinical Lead for Women’s Health in General Practice, the first such post in Ireland. This is currently being progressed and will enable the development of a comprehensive life-course approach to women’s health in General Practice.
- A number of health topics relating to women's health, including menopause, have recently been updated and are now live on the HSE A-Z. This information is an important first step towards delivering enhanced information and education on menopause. A public information webinar on the menopause is scheduled for November 29th 2021.
- A civil service webinar on 'Menopause at work' was held on October 18th, and further HR training to better understand the challenges and solutions for supporting women in their menopause journey within the civil service will be held on November 30th. The Healthy Workplace Framework is due to be published in the coming months. Following publication, an Implementation Group will be established with responsibility for developing an action plan. A representative from Women’s Health will be included on the Implementation Group to ensure the needs of women in the workplace are incorporated. This has particular reference to increased awareness of menopause within the workplace.
In addition to the activity outlined above, menopause will continue to be a priority for the Women's Health Taskforce for 2021 and 2022.
694. Deputy Ruairí Ó Murchú asked the Minister for Health the details of plans including future projected plans in relation to a site (details supplied); the engagements that have taken place on the matter; and if he will make a statement on the matter. [58980/21]
View answerAs the Health Service Executive is responsible for the management of the public healthcare property estate, I have asked the HSE to respond directly to you in relation to this matter.
695. Deputy Ruairí Ó Murchú asked the Minister for Health the position regarding the EU Digital COVID Certificate in relation to Irish citizens who received one dose of vaccination in Ireland and a second dose of the same vaccination type approved for use in Ireland in a non-EU Country; the process by which these citizens can obtain an EU Digital COVID Certificate; and if he will make a statement on the matter. [58981/21]
View answerIrish passport holders, who have reliable proof a vaccination regime completed outside of the EU, or third countries who have been awarded an equivalence decision under the EU Digital COVID Certificate Regulation, with a vaccine product authorised for use in Ireland, can apply for an EU Digital COVID Certificate online at covidcertificateportal.gov.ie.
696. Deputy Mark Ward asked the Minister for Health if he will report on the current levels of absenteeism for clinicians per CHO area; and if he will make a statement on the matter. [58993/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy, as soon as possible.
697. Deputy Michael Collins asked the Minister for Health if it was acknowledged that the child was deserving of the fundamental rights bestowed by the Constitution and entitled to human rights protections under relevant international law in cases in which babies were born alive having survived abortions; and if he will make a statement on the matter. [58995/21]
View answerAs the Deputy’s question relates to a service area, I have referred this question to the HSE for direct response.
698. Deputy Richard Bruton asked the Minister for Health if all general practitioners who administered the first two Covid-19 vaccines will also administer the third; if there is a location in which a priority request for a third vaccine can be lodged by a person who may have found that their general practitioner is not offering the option. [58996/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
699. Deputy Sean Sherlock asked the Minister for Health the number of persons over 18 years of age who are awaiting first-time intervention for occupational therapy, speech and language therapy, physiotherapy and psychotherapy in CHO4, by individual area in tabular form; and the length of time they have been awaiting intervention. [58997/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
701. Deputy Pádraig Mac Lochlainn asked the Minister for Health the number of capital funding requests submitted to his Department from Letterkenny University Hospital specifically to address the issue of bed capacity over the past three years; the amount requested; the amount provided by his Department; and if he will make a statement on the matter. [59000/21]
View answerAs the Health Service Executive is responsible for capital funding requests, I have asked the HSE to respond to you directly in relation to this matter.
702. Deputy Pádraig Mac Lochlainn asked the Minister for Health the number of new acute beds that have been provided to Letterkenny University Hospital in the past two years; and if he will make a statement on the matter. [59001/21]
View answerSaolta Hospital Group advise that an additional 39 beds were approved for Letterkenny University Hospital in 2020/2021. Of these, 16 beds are currently operational. The remaining 23 beds will become operational in February/March 2022, when staffing is in place.
