Written Answers Nos. 101-120
101. Deputy Steven Matthews asked the Minister for Health if his attention has been drawn to concerns in relation to medical card holders being unable to get dental appointments due to ongoing issues between dentists and the HSE; his plans to alleviate this issue; and if he will make a statement on the matter. [59207/21]
View answerYes, I am aware that medical card holders in certain areas of the country are experiencing difficulties in getting an appointment with their local dentist, and that is of real concern to me.
The problem is that too many dentists are leaving the Scheme for various reasons, and I want to see that situation reversed, so that we have an abundance of dentists available to provide services to medical card holders.
I've listened to the dentists myself, and I have heard their frustrations with the Scheme; that the range of services available to patients under the Scheme and the fees payable to contracted dentists are out of kilter in today’s environment.
I have given a commitment that there will be a root and branch review of the Scheme, and my officials and the HSE expect to be in a position to begin that work early in the New Year.
In the meantime, I want the contracted dentists, and their representative association, the Irish Dental Association, to work with me and my officials to address the immediate issues of concern and to ensure that as many dentists as possible are available to provide services to medical card patients.
I have heard what the dentists have had to say about the viability of the scheme, and I want that addressed to.
I have secured an additional €10 million in Budget 2022 to address that very problem and I hope that agreement can be reached very quickly on how that money can be used to address some of the immediate problems of the scheme, pending the full root and branch review next year.
I am aware that a preliminary engagement with the Irish Dental Association was held in June of this year, and that the intention is to invite the IDA in to further talks in the coming weeks.
I hope that the IDA will respond positively to that invitation and that we can put in place immediate solutions for the benefit of patients and the dental community.
In the meantime, my officials are engaging with the HSE Public Dental Service, the in-house salaried service, which is seeking to provide emergency cover for any medical card patients who are experiencing problems in accessing a service from their local dentist.
103. Deputy John Brady asked the Minister for Health if he will report on the work of the National Screening Advisory Committee in relation to the status of the expansion of the new-born screening programme; the conditions that are being considered for inclusion in the programme; the progress to date on the work being carried out by the Committee in consultation with his Department, the HSE, clinical experts, patient advocates and other key stakeholders; and if he will make a statement on the matter. [59218/21]
View answerI am strongly supportive of expanding our national newborn bloodspot programme.
Last year I approved the addition of a condition (ADA-SCID) to the Programme; other SCID types are now actively being formally assessed by HIQA, and work is ongoing on development of a pipeline of other conditions for formal assessment.
This is an area which can have a profound impact on the health and wellbeing of children and families, and it is important our approach is robust and in line with best international practice.
The work to expand the National Newborn Bloodspot Screening Programme is led by the National Screening Advisory Committee, an independent expert group which makes evidence-based recommendations to me.
As I mentioned, in 2020 I approved the addition of a condition known as ADA-SCID, which is a rare, inherited immune system disorder, to the Programme. The HSE is currently implementing this addition, bringing the number of conditions screened for by the Programme to nine.
The addition of other SCID types is currently being evaluated by the Committee. HIQA is undertaking a health technology assessment which will look at the evidence in a robust, systematic and transparent manner, and it is expected the Committee will have the findings of this review in 2022 to make recommendations to me.
Work is also being progressed by the Committee, working closely with my Department, the HSE, HIQA and other key stakeholders, including clinical experts and patient advocates, on further expansion of the Programme.
In addition, the Committee is currently conducting its first public call for suggested changes to screening programmes, including the newborn bloodspot screening programme. This is open until 23 December at gov.ie/screeningcall.
I look forward to further recommendations from the National Screening Advisory Committee on expansion of this important Programme in the coming year.
105. Deputy John Brady asked the Minister for Health the measures that are being taken to address the difficulties that persons in County Wicklow are experiencing in finding a general practitioner practice in the county that is able to take them on as a patient; and if he will make a statement on the matter. [59219/21]
View answerI would like to assure the Deputy that Government is committed to developing primary and community services in Wicklow and elsewhere. We also remain committed to the continued development of GP capacity to ensure that patients continue to have access to GP services.
Under the GMS scheme, the HSE contracts GPs to provide medical services without charge to medical card and GP visit card holders. Where a vacancy arises in a practice with a GMS contract, the HSE becomes actively involved in the selection process to find a replacement GP. Currently there are 76 GPs who hold GMS contracts in Co. Wicklow and no GMS vacancies.
The Government is aware, however, of the workforce issues currently facing general practice. While GMS patients are assisted in finding a GP by the National Medical Card Unit, who can assign them to a GMS panel, I recognise private patients can have difficulty in finding a local GP willing to accept them as a patient.
Several efforts to increase the number of practising GPs have been undertaken in recent years. Changes have been made to the entry provisions to the GMS scheme to facilitate more flexible/shared GMS contracts, and to the retirement provisions for GPs under the GMS scheme. An enhanced supports package for rural GP practices was also introduced.
Under the 2019 GP Agreement, the Government will increase annual expenditure in general practice by €210 million over the Agreement’s lifetime from 2019 to 2023. It provides for increases in capitation fees, improved maternity and paternity arrangements, as well as enhanced supports for rural practices and the introduction of a €2 million support for practices in deprived urban areas.
The number of entrants to GP training has increased from 120 in 2009 to 233 this year. Further increases are expected as responsibility for training has transferred from the HSE to the Irish College of General Practitioners.
Investment in the development of primary care services is continuing. In Wicklow alone, there are now seven operational Primary Care Centres, plus another in Arklow under construction and due to open next year. This represents new investment - Bray only became operational last year, Baltinglass in January of this year and I had the pleasure of opening the centre in Rathdrum just a few weeks ago. These facilities are designed to benefit the local community first and foremost, but they also support staff and GPs as well by enabling multi-disciplinary working and simply by being modern and purpose built working environments.
Our continuing investment in the wider primary care sector will hopefully encourage GPs to practice in Wicklow and elsewhere across the country.
107. Deputy Holly Cairns asked the Minister for Health the steps he is taking to address waiting lists for assessments and therapies for the children’s disability network teams in Cork south west. [59346/21]
View answerHSE Disability Services in Cork and Kerry reconfigured children’s disability services to Children’s Disability Network Teams under the Progressing Disability Services for Children and Young People Programme (PDS) in April 2021.
The re-configuration of Network Teams has been challenging, particularly, in regard to staffing issues. Currently, there are a number of vacancies on Children’s Disability Network Teams in each Community Healthcare Organisation, which are being progressed, as a matter of urgency, by HSE National Recruitment Services, and directly in the case of Section 39 Lead Agencies, in order to support Network Teams to optimise service delivery. These challenges arise due to the significant availability of new posts across the wider HSE in areas such as Primary Care and Services for Older People and also in the private sector. Coupled with this are temporary absences on some teams related to maternity leave and in other instances Covid related sick leave.
A further 100 therapy posts were allocated under the HSE National Service Plan 2021. Funding for these posts is facilitating each area to identify and address the discipline and grade most urgently required to fill immediate gaps in their Children’s Disability Network Teams to address issues such as waiting lists for therapy supports. In addition, the HSE is also employing an additional 85 Whole Time Equivalent Posts within those Network Teams to address a perceived diminution of service in special schools. The numbers were mapped by the HSE and I understand that Network Teams in Cork and Kerry will receive an additional 13.3 Whole Time Equivalent Posts of these posts.
Further additional new posts will also be announced as part of the HSE’s National Service Plan for 2022.
- Under PDS, completion of the Children’s Disability Network Team Configuration by the HSE will ensure;
A fairer system for access to services; a system that actually covers all parts of the country rather than where there areas with good services and, in contrast, pockets where there were effectively none.
Provision of more effective interdisciplinary teams – with a range of professionals working together, rather than some clinicians working solo, or isolated from professional support and referral options.
- Create efficiencies by ensuring the CDNTs provide a continuum of care for children with special needs from birth to 18 years, reducing the need for onward referral and allowing different professionals to work as one team, in one place, at the same time.
- In August 2020 the HSE was provided with €7.8m SláinteCare funding to address overdue Assessments of Need (AoN).
- In this regard, almost €1.2m was allocated to CHO4 and 1,100 overdue assessments in Cork and Kerry were processed and completed.
- There are 11 CDNTs based in Cork. The teams located in West Central Cork and in South Cork City cover the geographic area of Cork South-West.
The CDNT in West Central Cork has 26.19 WTEs, inclusive of a Network Manager and Admin Staff and has a current caseload of 721 children, not inclusive of waiting lists.
- The CDNT in South Cork City has 14.47 WTEs, inclusive of a Network Manager and Admin Staff and has a current caseload of 405 children, not inclusive of waiting lists.
108. Deputy Catherine Connolly asked the Minister for Health his plans for investment in additional MRI machines in County Galway; the details of analysis carried out or commissioned by his Department into the adequacy of MRI provision in County Galway; and if he will make a statement on the matter. [59480/21]
View answerI am advised by the HSE that currently one MRI scanner is operational in University Hospital Galway.
Building works commenced in September 2021 to facilitate the installation of a new second MRI machine. This will replace an existing 18 year-old machine as part of the HSE's equipment replacement programme. The old machine was in operation until mid-November, when it was removed and replaced by the new MRI machine. A 6 weeks period of commissioning is now being progressed. I am advised that the new machine will be operational in early January 2022.
Additional to that, as part of the new Radiation Oncology facility which is currently under construction at University Hospital Galway, a third MRI scanner will be provided by mid 2023.
I am also advised by the HSE that Portiuncula University Hospital has one MRI scanner on site. This MRI, which is not owned by the hospital, is a managed service that provides 1,800 scans annually for public patients. Portiuncula University Hospital can purchase more scans for public patients as required year to year.
Similarly, I am advised that a Service Level Agreement for a managed service is in operation at Merlin Park Hospital Imaging Centre providing MRI and CT scans for public patients.
109. Deputy Pearse Doherty asked the Minister for Health the number of applications received from patients in County Donegal for treatment pursuant to the cross-Border Directive in 2019, 2020 and 2021; the number of successful and unsuccessful applications; the reasons for each unsuccessful application in tabular form; and if he will make a statement on the matter. [58422/21]
View answerAs the Deputy will be aware the EU Cross-Border Directive allows patients to access treatment in another EU/EEA Member State and be reimbursed for that care by the HSE. In addition, earlier this year this Government introduced the NI Planned Healthcare Scheme to enable patients to continue to access private healthcare in Northern Ireland, post-Brexit, and be reimbursed by the HSE under similar parameters to the EU Cross-Border Directive.
The HSE advises that a breakdown of applications by County is collated for the NI Planned Healthcare Scheme but is not generally collated for the EU Cross-Border Directive. However, an analysis has been undertaken to collate data specific to Donegal to the greatest extent possible and is set out in a table as requested for the period 2019-2021 which can be provided to the Deputy.
I can confirm that to date in 2021 under both those schemes there were 788 reimbursement applications received by the HSE for persons with an address in Donegal, of which 514 have been approved to date and only 36 declined.
The HSE advises that reimbursements may be declined where an individual is not eligible for reimbursement; has not followed the public patient pathway or there is inaccurate or misleading documentation in the application process.
Where an application for reimbursement is declined, the decision letter will inform the patient of the reason for declining and importantly sets out the HSE appeals process.
|
Oral PQ 58422/21 - EU Cross-Directive & NI Planned Healthcare Scheme Reimbursement Applications for Persons with a Donegal Address |
|||
|
Year |
Total Reimbursement Applications Received |
Approved Reimbursement Applications |
Declined Reimbursement Applications |
|
2021 YTD - NI Planned Healthcare Scheme |
346 |
179 |
11 |
|
2021 YTD – EU Cross-Border Directive |
442 |
335 |
25 |
|
2021 YTD - Total |
788 |
514 |
36 |
|
2020 – EU Cross-Border Directive |
991 |
694 |
37 |
|
2019 – EU Cross-Border Directive |
1454 |
857 |
24 |
Note: The disparity between applications received and the number of decisions issued relates to applications awaiting processing or awaiting further documentation from the applicant.
110. Deputy Pa Daly asked the Minister for Health the breakdown of the number of in-patient beds available in the State for children with eating disorders. [58555/21]
View answerEnhancement of specialist services for eating disorders, including improved access and shorter waiting lists, remains a key priority for me and Government as a whole.
In circumstances where children require inpatient care, treatment can be provided in all 72 inpatient CAMHS beds across the country. Furthermore, Linn Dara and Merlin Park have a dedicated number of specialist eating disorder beds, 8 and 6 beds respectively. Additionally, there are plans for an Eating Disorder Unit in the new National Children’s Hospital, which will provide 8 additional beds.
There is strong evidence that inpatient mental health care is not required for most people with eating disorders. However, it is recognised that a small number of individuals will require inpatient care for short periods.
Specialist outpatient treatment has been found to be the most effective and fastest way for most people with eating disorders to recover. In line with the Eating Disorders Model of Care, there are currently 2 eating disorder specialist community teams based in CAMHS, with an additional team to be established by the end of this year. A further two CAMHS teams are planned for development in 2022. Children can also access treatment through the 72 CAMHS community teams nationwide.
Importantly, including funding for 2022, €6.85 million has been allocated to the Eating Disorders National Clinical Programme since 2016.
A total of 8 specialist eating disorder teams for CAMHS are recommended under the Model of Care and I am fully committed to ensuring the continued development of these services.
111. Deputy Brendan Smith asked the Minister for Health if he will ensure that the necessary provision of additional capacity at the National Orthopaedic Hospital, Cappagh is given urgent consideration; when the proposed project will proceed to the next stage; and if he will make a statement on the matter. [59424/21]
View answerThe National Orthopaedic Hospital Cappagh, is Ireland’s major centre for Elective Orthopaedic Surgery and offers a critical service to the people of Ireland. The hospital delivers specialist rehabilitation services to patients following an acute medical episode with the aim of returning them to independent living where possible.
The HSE has advised that NOHC has recently implemented a new initiative with Children’s Health Ireland to reduce the growing paediatric waiting lists for time dependent surgery for a younger cohort of patients (+2years).
The HSE has further advised that the NOHC and the Ireland East Hospital Group have made a submission to the HSE in relation to the future development of services in the Hospital. The submission includes a 10 Bed HDU, 76 Bed Single Occupancy Modular Build and three additional theatres. The proposal is currently under consideration by the HSE Capital Committee.
This project must progress through the various stages of the Public Spending Code and the HSE’s Capital Projects Manual and Approvals Protocol in the first instance. The project is still at an early stage and progress is subject to approval and availability of funding.
113. Deputy Róisín Shortall asked the Minister for Health his plans to establish a special joint Oireachtas committee on international surrogacy; when he expects this committee to commence its work; and if he will make a statement on the matter. [59256/21]
View answerIssues which arise from the undertaking of surrogacy arrangements in other jurisdictions concern areas of law that intersect across the remits of several Government Departments and require detailed examination. My Department is continuing to engage with the Department of Justice and the Department of Children, Equality, Disability, Integration and Youth in respect of these matters. It is expected that a proposal in this regard will be brought to Cabinet shortly.
As the Deputy will be aware, drafting of a bill on assisted human reproduction (AHR) and associated areas of research is being finalised by officials in my Department, in conjunction with the Office of the Attorney General. This legislation encompasses the regulation for the first time of a wide range of practices undertaken in this jurisdiction, including domestic surrogacy.
The surrogacy provisions of the Bill outline the specific conditions under which surrogacy in Ireland will be permitted, including a requirement for all surrogacy agreements to be altruistic and pre-authorised by the AHR Regulatory Authority, the establishment of which the Bill will also provide for. The legislation sets out a court-based mechanism through which the parentage of a child born through surrogacy may be transferred from the surrogate to the intending parent(s).
114. Deputy James Lawless asked the Minister for Health the status of the provision of a community neuro-rehabilitation team in CHO7; and if he will make a statement on the matter. [59248/21]
View answer‘The Programme for Government – Our Shared Future’ includes a commitment for advancing neuro-rehabilitation services in the community. The Health Service Executive (HSE) is leading on the implementation framework in respect of the recommendations of the National Policy and Strategy for the provision of Neuro-Rehabilitation Services in Ireland 2011-2015.
The overarching aim of the Strategy is the development of neuro-rehabilitation services to improve patient outcomes by providing safe, high quality, person -centred neuro-rehabilitation at the lowest appropriate level of complexity. This must be integrated across the care pathway and provided as close to home as possible or in specialist centres where necessary.
These services should be configured into population based Managed Clinical Rehabilitation Networks (MCRNs). The MCRN, while an effective model in a number of European countries, is a new concept in Ireland and is recognised as having the potential to bring together an appropriate range of primary, secondary and tertiary services to ensure equitable provision of high quality and clinically effective services.
An MCRN demonstrator project is currently progressing through the development of post-acute and community neuro-rehabilitation services across CHO 6 & 7, with full year funding of €2.29m available for 2021. This funding included the establishment of 10 additional in-patient beds in Peamount Healthcare which are now fully operational.
The learning from the demonstrator project will inform the implementation of the Neuro-rehabilitation Strategy across each CHO and implementation of strategy will roll-out from 2022.
As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
115. Deputy Gino Kenny asked the Minister for Health the steps he is taking to ensure that no other transplant operations are cancelled due to lack of ICU bed capacity; and if he will make a statement on the matter. [59508/21]
View answerThe HSE has advised that all necessary action is currently being undertaken in the context of the Covid-19 pandemic to ensure that organ donation and transplant services continue in so far as practically possible. However, due to the risk Covid-19 presents to transplant patients, and the negative impact increased pressure on ICU capacity has on transplant services, reduced levels of organ donation and transplant service activity will continue to be experienced during the pandemic.
The HSE has advised that Organ Donation and Transplant Ireland (ODTI) and the transplant centres have worked to ensure that the most time critical and life-saving transplants proceeded based on careful risk-benefit assessment.
In regard to critical care particularly, there is an acknowledged capacity deficit as set out in the Health Service Capacity Review which was noted by Government in 2018. In December last year, Government noted the Strategic Plan for Critical Care which aims to address this and which sets out a plan for reaching 446 critical care beds nationally over time. Very significant funding of €52m was provided by Government in 2021, and a further €10.5m this year, to progress implementation of the Plan. This funding has seen critical care capacity increasing from 255 permanent critical care beds in early 2020 to 297 currently, with the aim of reaching 340 by early 2023, a 33% increase.
116. Deputy Niamh Smyth asked the Minister for Health the investment that is being made in specialist eating disorder services; and if he will make a statement on the matter. [59194/21]
View answerEnhancement of specialist services for eating disorders, including improved access and shorter waiting lists, remains a key priority for me, Government as a whole and the HSE.
In 2018, the National Clinical Programme for Eating Disorders published a Model of Care in partnership with the College of Psychiatrists’ of Ireland and Bodywhys. The Model of Care has a core focus on developing regional community-based specialist eating disorder services provided by skilled multidisciplinary teams.
Since its establishment, €5.7 million has been allocated for the Eating Disorders National Clinical Programme up to 2020, of which €1.77 million had been invested prior to 2021.
In 2021, I secured the balance of €3.94 million and this has enabled further investment in specialist posts throughout the year. This will allow for the establishment of 3 new specialist eating disorder teams, as well as the completion of the 3 existing specialist teams in 2021. Services for both adults and children with eating disorders will be enhanced through the development of these teams.
Furthermore, I have ring-fenced an additional €1.15 million in funding for the programme in 2022. This funding will enable greater investment in specialist posts throughout next year, enabling the development of new specialist eating disorder teams in CHOs 1, 3, 5 and 6.
Including the funding available for 2022, a total of €6.85 million will have been allocated to the Eating Disorders National Clinical Programme since 2016, reflecting the Government’s ongoing commitment to providing and expanding high-quality treatment and support for all those affected by eating disorders.
118. Deputy Peadar Tóibín asked the Minister for Health the amount paid out by the State due to adverse events reported to the State Claims Agency related to the Health (Regulation of Termination of Pregnancy) Act 2018; and steps that are being taken to minimise adverse events related to the operation of termination of pregnancy services as indicated in the 94 incidents reported to the State Claims Agency and in all other recorded incidents reported to his Department. [58857/21]
View answerThe State Claims Agency hosts the National Incident Management System (NIMS) which is the principal source of national data on incident activity for the Irish public health service. Under the National Treasury Management Agency (Amendment) Act 2000 State authorities are obliged to report adverse incidents promptly to the State Claims Agency (SCA). This allows the SCA, in conjunction with State authorities, to identify and analyse developing trends and patterns and to work with the State authorities concerned to develop and implement risk mitigation strategies. It is also important in the investigation of any subsequent claim.
The SCA has informed me that to date, the SCA has made no payments in respect of adverse events relating to the Health (Regulation of Termination of Pregnancy) Act 2018.
The delivery of high quality, safe services is a priority within the Irish healthcare system. This is in line with the Sláintecare vision of Right Care. Right Place. Right Time.
An integral part of this is the appropriate and timely reporting of adverse events when they do occur. This information is important for healthcare services to learn so that care and experiences for patients and their families can continuously improve.
The HSE has systems and procedures in place to respond when an adverse incident occurs. This approach to incident management is cognisant of the needs of those affected and supports services to learn and improve.
119. Deputy Thomas Pringle asked the Minister for Health if his attention has been drawn to the existence of an internal HSE report into the falsification of blood glucose and blood ketone readings which was discovered in 2017 in St. Vincent’s University Hospital; and if he will make a statement on the matter. [58386/21]
View answer121. Deputy Thomas Pringle asked the Minister for Health if disciplinary proceeding were taken following an internal HSE report into the alleged falsification of blood glucose and blood ketone readings in 2017 in St. Vincent’s University Hospital; and if so, the outcomes of these proceedings; and if he will make a statement on the matter. [58388/21]
View answer169. Deputy Thomas Pringle asked the Minister for Health the actions that have been taken to ensure that blood glucose and blood ketone readings recorded on patient files match those recorded by electronic data management systems following an internal HSE report into the falsification of blood glucose and blood ketone readings in 2017 in St. Vincent’s University Hospital; and if he will make a statement on the matter. [58387/21]
View answerI propose to take Questions Nos. 119, 121 and 169 together.
I have made enquiries with the Health Service Executive (HSE) and the HSE has informed me that they can find no evidence of any healthcare audits relating to the specific matter referred to in the question.
The HSE has also advised that the Ireland East Hospital Group (IEHG) has advised that St. Vincent’s University Hospital (SVUH) has no knowledge of any internal HSE report into the falsification of blood glucose and blood ketone readings in St Vincent’s hospital in 2017.
The HSE has asked SVUH to undertake a wider review of other relevant records (e.g. complaints, HR and Incident Reports) to confirm that there is no evidence of falsification allegations. The hospital has confirmed that it would take any breaches seriously and address them with immediate action. In line with best practice in St. Vincent’s University Hospital, a number of hospital audits have been completed in relation to compliance with glucometer guidelines.
120. Deputy Richard Boyd Barrett asked the Minister for Health if he has read the recent NESC publication Building a New Relationship between Voluntary Organisations and the State in the Health and Social Care Sectors. [54564/21]
View answerAs the Deputy will be aware, the Report of the Independent Review Group established to examine the role of voluntary organisations in publicly funded health and social services, published in February 2019, highlighted the important contribution that voluntary organisations have made and continue to make in the delivery of health and social care services across the country.
The key finding in the Report is the need to strengthen the relationship between the State and the voluntary sector. To this end, a Dialogue Forum with Voluntary Organisations was established in December 2019 as recommended in the Report as a key mechanism for strengthening this relationship. The aim of the Forum is to build a stronger working relationship between the State and the voluntary healthcare sector for the benefit of patients and service users and to facilitate regular dialogue with the voluntary sector on future policy and strategic developments.
The Covid-19 crisis has brought into sharp relief both the hybrid nature of our health and social care system and the high level of mutual dependence of the statutory and voluntary sectors. In June 2020, the Dialogue Forum commissioned the NESC Secretariat to explore the healthcare system’s response to Covid-19 crisis and to examine the lessons which can be learned from successful partnership working during the pandemic response. As part of this work, NESC gathered on-the-ground case studies to illustrate ways in which Voluntary Organisations and the State collaborated in responding to the crisis in an effort to capture learning from this unprecedented event.
This Report, which, as the Deputy will be aware, was published in July, is now shaping the work of the Dialogue Forum. The NESC Report can be found online: www.nesc.ie/publications/building-a-new-relationship-between-voluntary-organisations-and-the-state-in-the-health-and-social-care-sectors/
