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Friday, 3 Dec 2021

Written Answers Nos. 161-180

Covid-19 Tests

Questions (161)

Jennifer Carroll MacNeill

Question:

161. Deputy Jennifer Carroll MacNeill asked the Minister for Health the status of the work taking place to implement antigen testing as another tool in the country’s defence against Covid-19; the educational material that will be made available for those who use antigen tests to ensure proper use; and if he will make a statement on the matter. [59206/21]

View answer

Written answers (Question to Health)

Testing and contact tracing continues to be a key component of the Irish Government’s response to the pandemic. Currently, PCR testing is the gold standard for diagnosis of SARS-CoV-2 infection and it is essential that people who have symptoms of Covid-19 continue to be advised to self-isolate and seek a PCR test from the HSE.

Rapid testing also has a role to play as another valuable tool in Ireland’s battle against COVID-19, and I have been very clear in supporting its wider use.

Antigen tests are already in use in Ireland, in appropriate settings and contexts:

- Asymptomatic fully vaccinated close contacts of a person that tested positive for COVID-19 can now test themselves at home using free antigen tests sent to them by the HSE

- In the health sector, the HSE has deployed antigen tests for use in acute hospital settings, and as part of the response to outbreaks in the community.

- In the agriculture sector, the HSE has supported the Department of Agriculture, Food, and the Marine in implementing an antigen testing programme in food processing facilities, supplementing the existing PCR serial testing programme.

- In the education sector, rapid testing pilot schemes have been underway in a number of universities, and also in other education and childcare settings, where the effectiveness and safety of self-swabbing and self-testing antigen test models are being evaluated.

- The HSE is also operating a pilot antigen detection testing programme for staff in a number of Residential Care Facilities for Older Persons across the country.

From Monday 29th November, as an additional measure to support parents and schools, free antigen tests are now offered for primary school children who are identified as close contacts as part of a pod in which there was a confirmed case of COVID-19. Where two or more confirmed cases of COVID-19 occur in a class within a seven-day period, outside of a single pod, antigen testing will be offered to the full class. All children in the pod can continue to attend school as long as they remain asymptomatic and they do not have a positive COVID-19 antigen or PCR test result.

As an additional precautionary measure for staff working in the classroom, where there is a

confirmed case in a pod, an SNA or teacher working closely with children in the pod may

also avail of the antigen tests and request them in the same way as parents/guardians are

instructed. Where there is an additional case in a second pod within seven days, then the class teacher and other staff members working in the classroom may also avail of the antigen tests .This is an entirely voluntary measure and staff should continue to attend the workplace unless they develop symptoms or receive a detected result on the antigen test.

A comprehensive, cross-Government communications campaign on the appropriate use of antigen tests, to ensure there is clear message to the general public on when and how they should be used has also been launched and guidance material has been published on the HSE website and on gov.ie. The HPSC has also published rapid antigen testing programme guidance. 

The role of testing and contact tracing, as part of the wider public health response, has been under ongoing review throughout the pandemic and will continue to be reviewed and amended in line with the epidemiological profile of the disease, its impact on healthcare utilisation and outcomes, the vaccination status of the population and ECDC guidance.

Health Services

Questions (162)

Joan Collins

Question:

162. Deputy Joan Collins asked the Minister for Health the steps he is taking to resolve the lack of services for assessments of need nationwide, particularly in CHO7 in which persons are waiting for more than 17 months on waiting lists. [57253/21]

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Written answers (Question to Health)

As the Deputy's question relates to a service issue, it has been referred to the HSE for direct reply. 

Patient Safety

Questions (163)

David Cullinane

Question:

163. Deputy David Cullinane asked the Minister for Health his plans to advance mandatory open disclosure, mandatory reporting and adult safeguarding legislation; when he plans to seek committee stage for the patient safety Bill; and if he will make a statement on the matter. [59118/21]

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Written answers (Question to Health)

The Patient Safety (Notifiable Patient Safety Incidents) Bill 2019 will for the first time introduce mandatory open disclosure for certain defined patient safety incidents that have occurred during the provision of clinical care in Irelands health and social services. The Department is working with the Office of the Parliamentary Counsel to finalise amendments to the Bill arising from its passage through the first and second stage of the Dáil. The Bill is expected to shortly come before the Committee Stage of the Dáil.

Regarding adult safeguarding, the Government takes the protection of adults at risk of abuse very seriously. There are various structures and processes currently in place to protect against abuse in the health and social care sector and to ensure prompt action. My Department is at an advanced stage of developing a national policy on adult safeguarding in the health and social care sector.  Subject to Government approval, this policy will further strengthen the sector’s adult safeguarding framework and will apply to all public, voluntary and private healthcare and social care settings and agencies under my Department’s remit. Legislation as required to underpin this sectoral policy will be prepared following its approval by Government.  

Separately, the Law Reform Commission is undertaking a review on A Regulatory Framework for Adult Safeguarding (across all sectors). Upon completion, this Department will consider any recommendations the Commission may make regarding legislation relevant to its functions and anticipates that other Departments will do the same.

Dental Services

Question No. 165 answered with Question No. 126.

Questions (164)

Duncan Smith

Question:

164. Deputy Duncan Smith asked the Minister for Health the engagement he has had with an association (details supplied) regarding the difficulties with access to dental care; and if he will make a statement on the matter. [59245/21]

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Written answers (Question to Health)

A new National Oral Health Policy, Smile agus Sláinte, was launched in April 2019. That Policy set out the roadmap for the future provision of oral healthcare to the eligible population. It has two key goals; first, to provide the supports to enable every individual to achieve their best oral health, and second, to reduce oral health inequalities across the population, by enabling vulnerable groups to access oral healthcare and improve their oral health. 

The Dental Treatment Services Scheme (DTSS), which dates from the 1990s is available to medical card holders aged 16 and over. The dental care is provided by independent dental practitioners who have a contract with the HSE. There is a need to align the DTSS with best international evidence and practice, and legislation, as outlined in Smile agus Sláinte. Regretfully, the COVID-19 pandemic caused the roll-out of the Policy to be delayed and the proposed review of the DTSS contract to be deferred. 

Nevertheless, there has been continued engagement between my officials, the HSE and the dental community throughout the pandemic on infection control measures, guidelines for safe dental practice, and ensuring that dental professionals were included in the high-risk group for early vaccination. This sustained engagement was with a view to ensuring that a safe satisfactory service could be continued for the eligible population. 

I have acknowledged that there is a need for a substantive review of the DTSS and have given a commitment that the review would be undertaken. I have also acknowledged the immediate issues of concern with current arrangements under the Scheme.  

I instructed my officials to hold talks with the Irish Dental Association (IDA) to address both issues. I am aware that preliminary talks were held in June this year and that it is proposed to hold further talks in the coming weeks.

I would also wish to point out that I secured additional funding of €10 million in Budget 2022 to address immediate issues with the DTSS, which is on top of the annual allocation of €56 million for 2022.

Question No. 165 answered with Question No. 126.

Hospital Services

Questions (166, 187)

Brendan Griffin

Question:

166. Deputy Brendan Griffin asked the Minister for Health his plans to resolve the ongoing crisis at University Hospital Kerry; and if he will make a statement on the matter. [59376/21]

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Brendan Griffin

Question:

187. Deputy Brendan Griffin asked the Minister for Health if he will visit University Hospital Kerry to meet with key stakeholders in an effort to address the challenges facing the hospital; and if he will make a statement on the matter. [59377/21]

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Written answers (Question to Health)

I propose to take Questions Nos. 166 and 187 together.

The Health Service Executive (HSE) has informed me that the National Director for Acute Operations and members of the South/ South West Hospital Group (S/SWHG) Management Team met with the Executive Management Board of University Hospital Kerry (UHK), Clinical Directors, representatives of the Consultant Group and other key stakeholders earlier this month in UHK to discuss challenges currently facing the hospital. 

The HSE has also advised me that in addition to the above meeting, the Interim Chief Operations Officer, S/SWHG was assigned to support UHK for a minimum of 2 days a week since the beginning of September 2021 and is supported by other members of the S/SWHG Management Team as required. The purpose of this is to work directly with the UHK Executive Management Board and clinical teams to support, stabilise and urgently address identified risks. This process will focus on the identification of delays within UHK patient flow streams and identify solutions, which mitigate associated patient risks. This arrangement was put in place to ensure that the S/SWHG will have the necessary assurances required with regard to the on-going safe management of patients in UHK.

The HSE has further advised that management at UHK and the S/SWHG are continuing to work in an integrated manner with their colleagues in Cork Kerry Community Healthcare to assist with patient flow and the application of the Five Fundamentals initiative and with Acute Operations to ensure that patients at UHK continue to receive the highest standard of care.  UHK and S/SWHG are committed to doing everything possible to continually seek to address the on-going issues whilst ensuring patient safety.

Covid-19 Tests

Questions (167)

Jennifer Carroll MacNeill

Question:

167. Deputy Jennifer Carroll MacNeill asked the Minister for Health the details of the work taking place to increase the capacity of the PCR testing system, including increased testers and enhanced laboratory resources to ensure readily available PCR test appointments and fast results; and if he will make a statement on the matter. [59205/21]

View answer

Written answers (Question to Health)

Testing and contact-tracing continues to be a key component of the Government’s response to the pandemic.

Demand for testing at this time is very high, with almost 220,000 tests conducted in the last seven days. This demand on the testing and tracing system is due to the high level of infection currently being experienced in the community.

The HSE is making every effort necessary to address the very significant demand arising for PCR testing. This includes making arrangements with private providers to add new capacity, extending the opening hours of swabbing centres and ongoing recruitment and redeployment to swabbing teams, and doubling the number of National Ambulance Service mobile teams. 

The HSE operates testing centres at locations around the country, details of which are available on the HSE website at hse.ie. The HSE also continues to monitor the need for testing centres and the most appropriate locations at any given time. Individuals who have a medical condition that prevents them from getting to a test centre can be referred by a GP for a home test.

These measures have increased the base community PCR capacity from 15,000 to 25,000 tests per day. Including acute hospital capacity, the HSE is now able to deliver 29,500 tests a day.

People using the self-referral online portal to book a test may find, at times, that no appointments are available. Appointments become available at various times during the day so people should try again later. If anybody with symptoms has concerns about booking a test, they should contact their GP.

As a result of this very high demand, the HSE is prioritising those who are clinically referred and symptomatic close contacts.

It is important to reiterate the public health advice that anybody waiting for a test who has symptoms of Covid-19, should continue to self-isolate until they are at least 48 hours’ symptom free. This should minimize any impact where a person may have to wait a number of days for a test.

The role of testing and contact tracing, as part of the wider public health response, has been under ongoing review throughout the pandemic and will continue to be reviewed and amended in line with the epidemiological profile of the disease, its impact on healthcare utilisation and outcomes, the vaccination status of the population and ECDC guidance.

Health Strategies

Question No. 169 answered with Question No. 119.

Questions (168)

Peadar Tóibín

Question:

168. Deputy Peadar Tóibín asked the Minister for Health the amount allocated to the National Maternity Strategy in each of the years 2018 to 2019; and the amount that was spent on termination of pregnancy related costs during the same period. [58856/21]

View answer

Written answers (Question to Health)

The National Women & Infants Health Programme was established within the HSE to lead the management, organisation and delivery of maternity, gynaecology and neonatal services. I am therefore referring this enquiry to the HSE for direct reply to you, as soon as possible.

Question No. 169 answered with Question No. 119.

Hospital Staff

Questions (170)

John Lahart

Question:

170. Deputy John Lahart asked the Minister for Health if additional neurology nurses are being recruited for Tallaght University Hospital and for St James’s Hospital; and if he will make a statement on the matter. [59232/21]

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 (171)

Christopher O'Sullivan

Question:

171. Deputy Christopher O'Sullivan asked the Minister for Health if provision will be made for persons in the older age cohorts who are finding it difficult to get to Cork city in order to get their booster vaccine given the centres in Clonakilty and Bantry are now closed; and if he will make a statement on the matter. [59305/21]

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.

Health Services

Questions (172)

Barry Cowen

Question:

172. Deputy Barry Cowen asked the Minister for Health his plans for the provision of a community neurorehabilitation team in CHO8; and if he will make a statement on the matter. [59252/21]

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.

Public Sector Pay

Questions (173)

Pádraig O'Sullivan

Question:

173. Deputy Pádraig O'Sullivan asked the Minister for Health if he has engaged with representatives from the public sector regarding pay equality; and if he will make a statement on the matter. [55891/21]

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Written answers (Question to Health)

I acknowledge and pay tribute to the dedication, professionalism and commitment of all medical scientists throughout the country and their drive and dedication, which has been a key component of our managing of the pandemic.

Health Management have been engaging with the MLSA on various industrial relations issues under the auspices of the WRC.

As you may be aware, the current Public Service Agreement, Building Momentum, includes the process of Sectoral Bargaining. The MLSA have requested and been facilitated with their own bargaining unit in the sectoral bargaining process which will be the mechanism they can use to advance their claim.

The Department of Health and the HSE remain open to engagement with the MLSA but are compelled to resolve any disputes in compliance with the provisions allowed for under Building Momentum.

Industrial Relations

Questions (174)

Duncan Smith

Question:

174. Deputy Duncan Smith asked the Minister for Health the engagement he or his Department has had with medical scientists and their union representatives regarding the 94% ballot for strike action by a union (details supplied); and if he will make a statement on the matter. [59243/21]

View answer

Written answers (Question to Health)

I acknowledge and pay tribute to the dedication, professionalism and commitment of all medical scientists throughout the country and their drive and dedication, which has been a key component of our managing of the pandemic.

Health Management have been engaging with the MLSA on various industrial relations issues under the auspices of the WRC. 

As you may be aware, the current Public Service Agreement, Building Momentum, includes the process of Sectoral Bargaining. The MLSA have requested and been facilitated with their own bargaining unit in the sectoral bargaining process which will be the mechanism they can use to advance their claim.

The Department of Health and the HSE remain open to engagement with the MLSA but are compelled to resolve any disputes in compliance with the provisions allowed for under Building Momentum.

Primary Care Services

Questions (175)

Willie O'Dea

Question:

175. Deputy Willie O'Dea asked the Minister for Health the number of persons currently waiting for a primary care psychology appointment in each local health office area in CHO3; and if he will make a statement on the matter. [59250/21]

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.

Disability Services

Question No. 177 answered with Question No. 155.

Questions (176)

Michael Moynihan

Question:

176. Deputy Michael Moynihan asked the Minister for Health when the transfer of disability services from his Department will occur; and if he will make a statement on the matter. [59349/21]

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Written answers (Question to Health)

Following the Government's announcement regarding the establishment of the Department of Children, Equality, Disability and Integration, arrangements are underway for the transfer of disability services to the new Department.

Given the scale of the transfer and the significant budget involved (c. €2.2bn in 2021), Human Resources, policy, legal and governance workstreams are underway within my Department to sequence the range of tasks necessary to effectively complete the transfer of responsibility. A Project Group has been created with representatives from both Departments to prioritise the project and senior officials have been assigned responsibility for this. Fortnightly bi-lateral meetings are taking place to ensure an efficient, collaborative approach to the overall programme of work. Relevant officials have also engaged with colleagues in the HSE.

Significant progress has been made. There is agreement as to the scale and scope of the services involved in the transfer. There was close cooperation between the two Departments in relation to the budget negotiations for 2022, which were led by my Department with strategic input from the Department of Children, Equality, Disability, Integration and Youth.   Following significant engagement, a governance model has been agreed to ensure there is an appropriate legislative basis to provide for a robust accountability structure between the Health Service Executive and Minister for Children, Equality, Disability, Integration and Youth.

On the 23rd of November 2021 Government approved the priority drafting of legislation, the Health (Amendment) Bill 2021, to enable the transfer. This work is progressing as a priority and the transfer will take place as soon as possible after the legislation is enacted.

Question No. 177 answered with Question No. 155.

Primary Care Centres

Questions (178)

Cathal Crowe

Question:

178. Deputy Cathal Crowe asked the Minister for Health the status of the provision of new primary care centres in County Clare. [59200/21]

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.

Health Strategies

Questions (179, 183)

Thomas Gould

Question:

179. Deputy Thomas Gould asked the Minister for Health if his attention has been drawn to the upset amongst community groups regarding the recent mid-term review of the National Drugs Strategy; and if he will make a statement on the matter. [59420/21]

View answer

Paul McAuliffe

Question:

183. Deputy Paul McAuliffe asked the Minister for Health if he will report on the mid-term Review of National Drugs Strategy and the Strategic Priorities for 2021-2025. [59426/21]

View answer

Written answers (Question to Health)

I propose to take Questions Nos. 179 and 183 together.

The Department of Health published the mid-term review of the actions in Reducing Harm Supporting Recovery and the report of the mid-term review was published on the 17th November.  The review identified six strategic priorities for the national drugs strategy for the period 2021-2025. 

The mid-term review was informed by a focussed policy assessment of expenditure on drugs and alcohol services, carried out by the Irish Government Economic and Evaluation Service (IGEES), new data on trends and indicators in drug and alcohol for 2019/2020, and the impact of Covid-19 on drug and alcohol services.   The Department undertook considerable engagement with stakeholders, including community organisations, voluntary drug and alcohol service providers, and drug and alcohol task forces as part of the Mid Term Review.  

Arising from the review, six strategic priorities were identified for the period 2021-2025. These will strengthen the health-led approach to drug use, as agreed in the Programme for Government, and align with the EU Drugs Strategy and Action Plan. The six strategic priorities are  

1. Strengthen the prevention of drug and alcohol use and the associated harms among children

and young people;

2. Enhance access to and delivery of drug and alcohol services in the community;

3. Develop integrated care pathways for high-risk drug users to achieve better health

outcomes;

4. Address the social determinants and consequences of drug use in disadvantaged

communities;

5. Promote alternatives to coercive sanctions for drug-related offences;

6. Strengthen evidence-informed and outcomes-focused practice, services, policies and

strategy implementation.

To drive the implementation of the strategic priorities for 2021-2025, new oversight structures have been developed to strengthen the partnership approach and give a stronger voice to civil society in developing national policy. These groups will have independent leadership to ensure the accountability of all stakeholders and to involve service users to provide insights from the lived experience of drug and alcohol addiction.  

As part of a review of the national oversight structures, the Department is proposing to establish a civil society group on drugs to widen and deepen the involvement of community and voluntary groups in the implementation of the strategy. The Civil Society group, as envisaged, will involve service users to ensure that insights from the lived experience of drug and alcohol addiction are represented.  

Additional funding of €6m for health measures was provided in Budget 2022 to support the implementation of the national drugs strategy and to strengthen the health-led approach.  

I can assure the Deputies that community and voluntary organisations will continue to have an active role in the design and delivery of the strategy, both at local level through the drug and alcohol task forces and at national level through the National Oversight Committee and strategic implementation groups.

Hospital Services

Questions (180)

Alan Dillon

Question:

180. Deputy Alan Dillon asked the Minister for Health the additional bed capacity and capital projects will be delivered at Mayo University Hospital as part of the HSE Winter Plan 2021-2022; and if he will make a statement on the matter. [59470/21]

View answer

Written answers (Question to Health)

There has been significant investment in acute bed capacity in recent years. €236 million revenue and €40 million capital expenditure were provided nationally last year to fund additional beds on a permanent basis in our acute hospitals. To date, the Winter Plan / Budget 2021 has provided 799 non-ICU acute beds to the hospital system over the number available on 1 January 2020. As part of this, 10 additional beds were opened in Mayo University Hospital in January 2021.

A number of capital projects are ongoing at Mayo University Hospital to increase capacity and improve patient flow. The extension project to the Emergency Department at the Hospital comprises a new extension to the ED, reconfiguration of the existing ED with 7 additional ED assessment & treatment spaces, and a new first floor Medical Assessment Unit with 10 spaces.  It is envisaged that a design team will be selected, and that the design process will commence, by January 2022.  An indicative project timeline envisages completion of construction in 2026.

I published The HSE Winter Plan for Winter 21/22 on 15th November. The Government allocated an additional €1.1bn, including winter funding, in budget 2021 to support health services in the acute, community care, and primary care sectors and this is being maintained in 2022. The Plan centres on three core objectives: ED avoidance, patient flow and hospital egress to mitigate the expected challenges in providing emergency care this winter while also continuing to respond to Covid 19.

Specific measures, with a full year cost of €77m, include provision of Aids and Appliances; GP and Out of Hours supports; Social Inclusion; Older Persons Hospital Discharge Liaison; Transitional Care Beds; Hospital Avoidance / ED Front Door Initiatives; Acute Diagnostic; Disability supports; Mental Health supports; Palliative Care. As such, the Plan recognises that a whole system response is required and outlines how the HSE proposes to manage these challenges across primary, community and acute care including measures to allow the public system to access private healthcare capacity.

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