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Friday, 3 Dec 2021

Written Answers Nos. 141-160

Hospital Services

Questions (141)

Pearse Doherty

Question:

141. Deputy Pearse Doherty asked the Minister for Health the action he has taken following the raising of governance issues by HIQA in its report entitled Report of the Targeted Assurance Review of the Governance Arrangements of Gynaecology services at Letterkenny University Hospital; and if he will make a statement on the matter. [58421/21]

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Written answers (Question to Health)

The clinical services review of gynaecology services at Letterkenny University Hospital (LUH) (the Price Report) found a number of challenges in the service.  Following the publication of the Price Report in August 2020, the Saolta University Health Care Group have been working closely with LUH to deliver on a detailed plan to implement the report’s recommendations.

HIQA’s Report of the Targeted Assurance Review of the Governance Arrangements of Gynaecology services at LUH identified governance structures and instances of failure to meet referral timelines as core areas of weakness at LUH.  In response the Saolta University Health Care Group have commenced a process to identify and engage a team to support the roll out of further service improvement in LUH and the Saolta Group. Discussions are ongoing with a Service Improvement Team from the NHS Scotland in relation to provision of support to LUH to achieve further service improvements.  This Team will also focus on improving governance arrangements between LUH and the Saolta Group.

The Saolta Group continues to oversee the implementation of the recommendations made in both the Price report and the HIQA report.  An Implementation Group convened in September 2020 remains in place and continues to oversee implementation of the recommendations and service improvements to ensure all are fully implemented and to assure sustainability of the improvements.

My Department continues to engage with the HSE and the Saolta Group on this important matter.

Health Services

Questions (142)

Richard Bruton

Question:

142. Deputy Richard Bruton asked the Minister for Health the progress to date in implementing the strategies in relation to drug use and drug treatment outlined in the Programme for Government. [59427/21]

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Written answers (Question to Health)

The Programme for Government: Our Shared Future, under the Mission: Universal Health Care, commits to a Health-led Approach to Drugs Misuse. Substance abuse and addiction affects people from all walks of life. By treating the use of substances as a public health issue, rather than solely as a criminal issue, we can better help individuals, their families, and the communities in which we all live. We are concerned about the increasing prevalence of illegal drug use over recent decades.

The National Drugs Strategy, Reducing Harm, Supporting Recovery 2017-2025, provides a roadmap to achieving these aims, by promoting a more compassionate approach to people who use drugs, with addiction treated first as a health issue.

The Department published the mid-term review of the national drugs strategy and the six strategic priorities for the remaining four years of the strategy, 2021-2025. The mid-term review of the strategy shows significant progress in implementing the action plan for the period 2017 to 2020, with only a small number of the 50 actions outstanding.

Main achievements are improved access & availability of drug services, especially services for women, people who are homeless & those with heroin addiction; a new clinical programme for dual diagnosis; and the development of a health-led approach to the possession of drugs for personal use.

The six strategic priorities will strengthen the health-led approach to drug use and align with the EU Drugs Strategy and Action Plan. An aim of the six strategic priorities is to capture the commitments under the Health-led Approach to Drugs Misuse.

Budget 2021 provided an allocation of €10m for new development relating to drugs policy and inclusion health. This funding included €4.1m for drug and alcohol services, €3.8m for the addiction and health needs of people who are homeless and €2.1m to enhance access to health services for other socially excluded groups. 

In Budget 2022, Minister Frank Feighan secured an additional €6m for new measures to support the implementation of the national drugs strategy, 'Reducing Harm Supporting Recovery'. This funding will be used to strengthen the health-led approach to drug and alcohol use, as set out in the

Programme for Government. 

Disability Services

Questions (143)

Thomas Pringle

Question:

143. Deputy Thomas Pringle asked the Minister for Health if he has received a response from the Department of Justice regarding recent correspondence in relation to the Brandon Report; and if he will make a statement on the matter. [57781/21]

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Written answers (Question to Health)

The HSE commissioned the National Independent Review Panel to carry out a review of a residential service for adults with a disability.  The review report, known as the Brandon Report, focuses on matters of a sensitive nature, and how they were managed. 

A response to recent correspondence concerning the report was received from the Minister for Justice.  It included clarification that the Minister for Justice had not received a written update on the matter from the ODPP, nor would it be appropriate for her to receive such an update.

Hospital Staff

Questions (144)

Willie O'Dea

Question:

144. Deputy Willie O'Dea asked the Minister for Health if additional neurology nurses are being recruited for University Hospital Limerick; and if he will make a statement on the matter. [59249/21]

View answer

Written answers (Question to Health)

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 (145)

Duncan Smith

Question:

145. Deputy Duncan Smith asked the Minister for Health the advice NIAC has provided to him regarding vaccinations for 5 to 11 year olds; and if he will make a statement on the matter. [59242/21]

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Written answers (Question to Health)

The immunisation programme in Ireland is based on the advice of the National Immunisation Advisory Committee (NIAC). The Committee reviews data relating to Covid-19 vaccines on a rolling basis and makes recommendations on vaccination policy to my Department.

Following the recommendation for use of vaccines against Covid-19 by the European Medicines Agency (EMA) and authorisation for use by the European Commission, the NIAC develops guidance for their use in Ireland which is contained in the Immunisation Guidelines for Ireland. These guidelines are continuously updated and include guidance on all new vaccines as they are approved for use in Ireland.

You can read the guidelines at: www.hse.ie/eng/health/immunisation/hcpinfo/guidelines/covid19.pdf.

On 25 November, the EMA recommended granting an extension of indication for Covid-19 vaccine Comirnaty to include use in children aged 5 to 11. The NIAC is currently reviewing these findings and will make a recommendation on the issue of vaccinations being extended to those aged 5 -11 years in due course.

Disability Services

Questions (146)

Pauline Tully

Question:

146. Deputy Pauline Tully asked the Minister for Health the achievements to date in relation to the decongregation of large residential institutions for persons with disabilities; and if he will make a statement on the matter. [59472/21]

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Written answers (Question to Health)

Ten years ago, the Time to Move on from Congregated Settings Report identified approximately 4,000 people with disabilities living in congregated type settings. The 2011 Report expected that decongregation could happen at a much faster pace than was actually possible.

Since 2014, the Transforming Lives Programme provides the framework for implementation and for putting policy into practice across key reports, including  Time to Move on from Congregated Settings in respect of residential centres. Today less than 2,000 people live in congregated settings.

The Programme for Government – ‘Our Shared Future’ includes a commitment to continue with moving people out of old style congregated settings, into new homes within the community, with the necessary supports. Today, people are being supported to live lives of their choice out in the community. Several congregated settings have closed fully and many more have closed specific units within the centres.

Thoughtful planning, capacity building work with stakeholders and sharing the learning across services is enabling meaningful person-centred planning and transitions that are sustainable.  While the pace of change has been slow in some services, there is momentum and progress is being made.  

Budget 2021 provides for an unprecedented level of investment in disability services, with the investment of €100m for new initiatives in 2021. The increased level of funding in 2021 will enable us to build on initiatives currently underway, including the decongregation programme, with a renewed focus on assisting people to move out of congregated settings to homes in the community. The HSE has prioritised the transition of a further 144  people from congregated settings in 2021 under its Service Plan. As the numbers in the large settings continues to fall, the people still remaining in these services have access to better living conditions and share with fewer people. 

As this Parliamentary Question relates to an operational issue,I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.

Ambulance Service

Questions (147)

David Stanton

Question:

147. Deputy David Stanton asked the Minister for Health if he is satisfied that the National Ambulance Service has sufficient resources to carry out its remit; and if he will make a statement on the matter. [59241/21]

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Written answers (Question to Health)

As the Deputy will be aware, the Programme for Government commits to increasing capacity in our National Ambulance Service (NAS).  In this regard the Government is investing significantly in building service resilience into the NAS as well as providing for its continuing strategic reform from an  emergency medical service into a modern, responsive and agile mobile medical service in line with the aims of Sláintecare to deliver the right care, in the right place, at the right time.  

Year-on-year increases in financial investment in the NAS have since 2016 provided for a staffing growth of some 16%.  Today the NAS has a staffing complement of over 2,000 whole time equivalents - up from just under 1,750 at the end of 2016.  This year, the NAS received its largest allocation to date of €187.5 million which included €10 million to provide for new service developments including:

- Continuing to target capacity deficits as identified in the NAS emergency service baseline and capacity review;

- Progressing the development of alternative patient care pathways to manage low acuity calls in an integrated manner in partnership with other healthcare providers; 

- Strengthening the capacity of the NAS critical care and retrieval services;

In 2022, the National Ambulance Service will receive its largest overall investment to date of €200.7m - up by some €30 million from that allocated in 2019.  This total includes a further €8.3 million to progress new service developments including the provision of additional frontline staffing to further address capacity deficits. 

I can assure the Deputy that the Government remains committed to increasing capacity in the NAS and supporting its continued strategic reform.

General Practitioner Services

Questions (148)

Joe Flaherty

Question:

148. Deputy Joe Flaherty asked the Minister for Health the measures that are being taken to strengthen general practice; and if he will make a statement on the matter. [59355/21]

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Written answers (Question to Health)

The Government is aware of the workforce issues currently facing general practice, including the limited access to GP services in certain areas. The Government has committed to providing significant additional resources to general practice to help to meet those challenges. We are working to ensure patients across the country continue to have access to GP services and that general practice is sustainable in all areas into the future.

Several efforts to increase the number of practising GPs have been undertaken in recent years. The number of entrants to GP training has increased from 120 in 2009 to 233 this year, with large increases made in recent years. Further increases are expected as responsibility for training has transferred from the HSE to the Irish College of General Practitioners. 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.

Recent developments in relation to general practice, in particular the 2019 Agreement on Contractual Reform and Service Development, have helped to re-establish general practice in Ireland as an attractive career choice.  The additional investment, which will amount to €210 million annually once the Agreement is fully implemented, provides for an increase in capitation fees, improved maternity and paternity arrangements as well as enhanced supports for rural practices. In addition, targeted funding of €2 million will also be set aside to provide additional support to practices in deprived urban areas. The wider reforms in the health service will also help to provide an atmosphere in which the practice of medicine in Ireland will remain attractive. The additional investment in general practice provides a sound basis for ensuring that GPs have access to a credible and rewarding career path in Ireland.

Mental Health Services

Questions (149)

Niamh Smyth

Question:

149. Deputy Niamh Smyth asked the Minister for Health if he will report on the development of perinatal mental health services;; and if he will make a statement on the matter. [59193/21]

View answer

Written answers (Question to Health)

As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

Covid-19 Pandemic

Question No. 151 answered with Question No. 130.

Questions (150)

Violet-Anne Wynne

Question:

150. Deputy Violet-Anne Wynne asked the Minister for Health the steps his Department has taken to address the difficulties those suffering from long-Covid-19 have in accessing disability, supports and treatment; and if he will make a statement on the matter. [59227/21]

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Written answers (Question to Health)

COVID-19 is a new disease so information on it, its features, incidence and its course are still emerging. The natural history, clinical course and consequences of COVID19 are still not completely understood. It is recognised that most patients with COVID-19 return to baseline after acute infection with SARS-CoV-2, but a proportion report ongoing health issues.

The number of people that are affected with longer term sequelae after acute COVID-19 remains unknown, but published reports indicate that approximately 10– 20% of COVID-19 patients experience lingering symptoms for weeks to months following acute SARS-CoV-2 infection.

Several organisations and societies have proposed different definitions based upon the constellation of symptoms that affect people after acute SARS-CoV-2 infection. To aid recognition and management of those affected, the WHO has recently through a global consensus process proposed a working clinical case definition of Post COVID-19 syndrome occurring 3 months from the onset of COVID-19, with symptoms that last for at least 2 months and cannot be explained by an alternative diagnosis. Common symptoms include fatigue, shortness of breath, cognitive dysfunction and others which generally have an impact on everyday functioning. Symptoms may be new onset, following initial recovery from an acute COVID19 episode, or persist from the initial illness. Symptoms may also fluctuate or relapse over time. However, the WHO notes that this definition may change as new evidence emerges and our understanding of the consequences of COVID-19 continues to evolve.

COVID-19 in children is usually asymptomatic or manifests as a mild illness of short duration. However, concerns have been raised regarding prolonged illness in some children, with no clear resolution of symptoms several weeks after onset, as is observed in some adults and this is an area of ongoing research. Studies to date have identified that that long illness duration after SARS-CoV-2 infection in school-aged children does occur but is uncommon and less common than is reported in adults. In most studies of children affected, symptoms are reported to have resolved or significantly decreased over time, providing reassurance about long-term outcomes. Additionally, studies suggest that the symptom burden in children with what has been termed long COVID-19 was not greater than that in children with long illnesses due to causes other than SARS-CoV-2 infection.  

Patients with persistent symptoms following COVID-19 infection may be followed up by their GP or in hospital settings as clinically appropriate. People in the community who are concerned about persistent symptoms following Covid-19 should contact their GP in the first instance. Treatment is currently focused on management of specific symptoms.

Specific guidance on the treatment of 'Long COVID' is presently under development both here and internationally.  The HSE is currently assessing need and the best way to care for those impacted by Long COVID to ensure the appropriate supports are in place. As part of this work on post-COVID care, the HSE is examining how it can model the possible numbers that will be affected, noting that this will take time as more evidence emerges. I understand that the HSE has also been in touch with a group of people who are suffering post-COVID symptoms to inform understanding. You may wish to note, that a  Programme Manager/Implementation Lead and Clinical Leads have been identified within the HSE who will be key stakeholders in driving this programme of work.

My Department, through the Health Research Board, continues to fund research into the clinical impacts of COVID-19. My Department will also continue to develop an understanding of the implications of Long COVID to inform policy as appropriate.

Question No. 151 answered with Question No. 130.

Home Care Packages

Questions (152)

Jackie Cahill

Question:

152. Deputy Jackie Cahill asked the Minister for Health the measures in the HSE Winter Plan 2021-2022 that will enhance homecare provision for older people; and if he will make a statement on the matter. [59353/21]

View answer

Written answers (Question to Health)

As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.

Covid-19 Pandemic

Questions (153)

Pádraig O'Sullivan

Question:

153. Deputy Pádraig O'Sullivan asked the Minister for Health if there are plans to address the fact that persons with myocarditis are unable to get the Covid-19 vaccine and therefore do not qualify for an EU Digital Certificate; and if he will make a statement on the matter. [57707/21]

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Written answers (Question to Health)

The current high level of COVID-19 infection and the dominance of the significantly more transmissible Delta variant poses a very substantial threat, particularly to those who are not fully protected through vaccination. Public health advice remains that those who are not fully vaccinated should avoid congregated indoor settings for their own and others safety.

The National Public Health Emergency Team gave some consideration to the issues arising for those people that cannot receive a COVID-19 vaccine for medical reasons as part of its discussions on the 18th October 2021 on the continuing response to COVID-19 and the extension of Covid Pass arrangements. The matter is being given further consideration.

The Deputy may wish to be aware that as outlined in Chapter 5a of the Immunisation Guidelines for Ireland, those with a contraindication to one mRNA COVID-19 vaccine should not receive another authorised mRNA vaccine. Consideration may be given to non-mRNA vaccination for anyone 18 and older including pregnant women. This should be given after an interval of at least 28 days and the person should be considered fully vaccinated. The Immunisation Guidelines can be found online: www.hse.ie/eng/health/immunisation/hcpinfo/guidelines/.

Eating Disorders

Questions (154)

Pa Daly

Question:

154. Deputy Pa Daly asked the Minister for Health his views in relation to Sharing the Vision: A Mental Health Policy for Everyone; and the way it applies to those with eating disorders. [58556/21]

View answer

Written answers (Question to Health)

As this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.

Health Strategies

Questions (155, 177)

Cormac Devlin

Question:

155. Deputy Cormac Devlin asked the Minister for Health if there will be a successor to the Neuro-Rehabilitation Strategy; and if he will make a statement on the matter. [59231/21]

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Cormac Devlin

Question:

177. Deputy Cormac Devlin asked the Minister for Health the status of the provision of a community neurorehabilitation team in CHO6; and if he will make a statement on the matter. [59230/21]

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Written answers (Question to Health)

I propose to take Questions Nos. 155 and 177 together.

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

Dental Services

Questions (156)

Neasa Hourigan

Question:

156. Deputy Neasa Hourigan asked the Minister for Health when the Bearn and Richmond report presented to the HSE in February 2015 into allegations that children were damaged in the public orthodontic service will be published; and if he will make a statement on the matter. [59429/21]

View answer

Written answers (Question to Health)

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 (157)

Martin Kenny

Question:

157. Deputy Martin Kenny asked the Minister for Health the reason a cardiac catheterisation lab is currently available for two days per week to cardiac patients at Sligo University Hospital; the details of the most recent review of catheterisation laboratory services in Sligo University Hospital; the number and position of staff attached to the lab; the number of patients treated there since 2016 to date in 2021; the plans of his Department to extend the service; and if he will make a statement on the matter. [55672/21]

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Written answers (Question to Health)

The Steering Group for the National Review of Specialist Cardiac Services, under the Chairmanship of Professor Phillip Nolan, is comprised of stakeholders representing medical staff, professional/technical staff, nurses and patients. The aim of the Review is to maximise patient outcomes at population level, with particular emphasis on the safety, quality and sustainability of the services that patients receive, by establishing the optimal configuration of a national adult cardiac service.

The Covid-19 pandemic impacted on progress of the National Review of Specialist Cardiac Services during 2020 and into 2021. This was particularly so as the Chair of the Review Steering Group has played a key role in the national Covid response. as Chair of the Irish Epidemiological Modelling Advisory Group and as a Member of NPHET. However, the Review is now progressing, and the Steering Group has reconvened. The Group met most recently on 22nd November, and is scheduled to meet again in mid-December. It is necessary to complete the Review to inform decision making on investment in Specialist Cardiac Services in Ireland.

The Cardiac Catherisation Laboratory service in Sligo University Hospital is operating 1 to 2 days per week (mobile service) delivering diagnostic angiographies, with referral pathways to University Hospital Galway for PCIs and other specialist Cardiology interventions. Two permanent Consultant Cardiologist posts were advertised this year, one of which was filled.

A decision will not be made in relation to future Cath Lab Services until the outcome of the National Cardiology Review is known.

The table below detailing the number of patients treated at the Cath Lab in Sligo University Hospital from 2016 to date in 2021;

Year

OUT PT

IN PT

TOTAL

2016

210

120

430

2017

306

122

428

2018

330

132

462

2019

268

167

435

2020

184

105

289

2021

136

62

198

Health Services

Questions (158)

Seán Haughey

Question:

158. Deputy Seán Haughey asked the Minister for Health the additional investment that is being provided for the development of dementia services in 2022; and if he will make a statement on the matter. [59235/21]

View answer

Written answers (Question to Health)

I am, along with Government as a whole, committed to ensuring that those living with dementia have access to the right services and supports to help them to live well in their communities.  

I was delighted to secure an additional allocation of €7.3 million in Budget 2022 for dementia services. I am confident that this investment will continue to improve diagnosis and access to services for people with dementia across the country .

The Health Service Executive’s National Service Plan 2022 has not yet been finalised and, as such, the sub-allocation has yet to be formally agreed. The details will be finalised over the coming weeks with the HSE through the National Service Plan process. However, as previously announced areas for investment will include memory assessment and support services, memory technology resource rooms, the national intellectual disability memory service and a dementia registry. 

In addition to the €7.3m, the proportion of new home support hours ringfenced for people with dementia will more than double from 5% in 2021 to 11% in 2022.

Taken together, this will represent 15 million euro of investment dedicated to dementia in 2022, on top of the €12.9million of additional funding in 2021.

As the Deputy is aware I have long been an advocate for the development of services for people with dementia and their families and I am delighted to be able to continue the focused investment in these services and supports.

Hospital Services

Questions (159)

Dara Calleary

Question:

159. Deputy Dara Calleary asked the Minister for Health the initiatives that are being taken to support services in the district hospitals in Ballina, Belmullet and Swinford, County Mayo; and if he will make a statement on the matter. [59071/21]

View answer

Written answers (Question to Health)

As this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.

National Development Plan

Questions (160)

Richard Bruton

Question:

160. Deputy Richard Bruton asked the Minister for Health his ambition for health capital development within the National Development Plan. [59428/21]

View answer

Written answers (Question to Health)

The National Development Plan (NDP) 2021 – 2030, launched on 4 October 2021, includes a total public investment over the period of €165bn.

My department has been given a 5-year allocation to 2025 of €5.657bn. This is an over 10% increase in funding year on year to 2025 and demonstrates commitment to the ongoing investment in health infrastructure and reform in line with Sláintecare.

Allocation to specific projects and programmes through the country is carried out in the sector in the capital planning process. The capital planning process for 2022 and beyond is underway involving my department, the HSE and other stakeholders.  

Capital plans will be developed taking account of factors including available funding, levels of contractual commitments and review and prioritisation of projects within these parameters including patient safety and regulatory compliance, reorienting the model of care towards primary and community settings, addressing capacity and infrastructural deficits and investment in eHealth, in line with Sláintecare. All capital projects go through the Public Spending Code. 

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