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Friday, 3 Dec 2021

Written Answers Nos. 181-200

Health Services

Questions (181)

Jim O'Callaghan

Question:

181. Deputy Jim O'Callaghan asked the Minister for Health if he will report on the review of the Neuro-Rehabilitation Services in Ireland from Theory to Action Implementation Framework 2019-2021 and the development of the framework for 2022-2024; and if he will make a statement on the matter. [59237/21]

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Written answers (Question to Health)

Programme for Government – Our Shared Future’  includes a commitment for advancing neuro-rehabilitation services in the community. The Health Service Executive 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. MCRNs are 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. 

The Neuro-Rehabilitation Strategy Implementation Framework (IF) from Theory to Action, was launched by the Health Service Executive in February 2019.

Considering the scale of fundamental change proposed, it was decided to advance a demonstrator project and funding became available for the demonstrator from Q4 2020, with full year funding available for 2021. The learning from the demonstrator project will inform implementation of the Neuro-rehabilitation Strategy across each CHO area. 

As a review of the Implementation Framework relates to service matters, I have asked the Health Service Executive (HSE)  to reply directly to the Deputy.

Ambulance Service

Question No. 183 answered with Question No. 179.

Questions (182)

David Cullinane

Question:

182. Deputy David Cullinane asked the Minister for Health the status of the capacity review of the National Ambulance Service; his plans to increase resources for the service; his engagement with the Minister of State with special responsibility for Local Government and Planning regarding funding for Dublin City Council to fund the Dublin Fire Brigade; and if he will make a statement on the matter. [59116/21]

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Written answers (Question to Health)

The Emergency Service Baseline and Capacity Review, submitted to Government in May 2016, identified capacity deficits within the National Ambulance Service (NAS).  It also noted that there was a shortage of qualified paramedics in Ireland, meaning that capacity must be increased incrementally. On that basis the NAS has been increasing paramedic WTEs year-on-year through implementation of the Vision 2020 strategic plan  Since 2016 the total NAS staff complement, including frontline staff has risen by some 16%.     

In order to support workforce planning over the longer term, the NAS has commissioned an updated independent analysis of demand and capacity. The results of this analysis will provide greater clarity in relation to staffing requirements over the coming years. 

Regarding Dublin Fire Brigade (DFB), as the Deputy will be aware, DFB provides emergency ambulance services in Dublin city and county by arrangement between Dublin City Council (DCC) and the Health Service Executive (HSE).  The NAS also provides some emergency capacity within the greater Dublin area.  The HSE has been engaged in discussions with Dublin City Council and the DFB regarding funding and service delivery in Dublin.  These discussions are ongoing.    

Question No. 183 answered with Question No. 179.

Departmental Strategies

Questions (184)

Denis Naughten

Question:

184. Deputy Denis Naughten asked the Minister for Health if he plans to establish a carers' commission to address the issues being experienced by family carers; and if he will make a statement on the matter. [57449/21]

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Written answers (Question to Health)

As Minister for Health, I recognise that Family carers are the backbone of care provision in Ireland. They deserve support and recognition from Government. My Department and I are committed to listening to family carers and their representative groups to ensure that we are providing the most appropriate supports to help sustain carers in their caring role. 

As the Deputy will be aware, my Department is responsible for coordinating the cross-departmental National Carers' Strategy and leading on the health aspects of the strategy. Within this context, there are a number of fora through which my Department regularly communicates and consults with key stakeholders, including groups representing the interests of family carers.

In September 2020, the Minister for Older Persons and Mental Health held a carers round table to listen to the concerns raised by family carers, including their experience during the Covid-19 pandemic. My Department also actively participates in the Annual Carers' Forum organised by the Department of Employment Affairs and Social Protection.

General Practitioner Services

Questions (185)

David Cullinane

Question:

185. Deputy David Cullinane asked the Minister for Health his plans for addressing the crisis in general practice, generally and specifically in out-of-hours services; the impact of this on emergency departments; and if he will make a statement on the matter. [59114/21]

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Written answers (Question to Health)

The Government is aware of the workforce issues facing general practice, including changing demographics, the number of GPs nearing retirement, the difficulties in filling a small number of GMS vacancies, and the impact of the shift towards care centred in the community on general practice.  The Government has committed to providing significant additional resources to general practice to help to meet those challenges.

The 2019 Agreement with GPs will see investment in general practice increase by approximately 40% (€210 million) between 2019 and 2023.  Specific initiatives benefiting patients arise from the 2019 Agreement, such as the introduction in 2020 of the Chronic Disease Management Programme to facilitate improved care for patients with diabetes, chronic heart disease, COPD, and asthma. As the Programme is rolled out and fully implemented over time, it will mitigate the reliance on hospitals for care of patients with the four conditions.

We have also provided resources to allow GPs to refer patients directly to diagnostic services. As of mid-September 2021, the HSE reported that over 70,000 scans of various modalities have been completed under the community diagnostics programme.  Provision of timely direct access to diagnostics to GPs can enable integrated care delivery, reduce ED attendances and facilitate hospital avoidance particularly for the over 75 age group. This programme will be continued into the future, and resources have been allocated in Budget 2022.

In addition, the 2019 Agreement provides for significant increases in capitation fees for participating GPs, and new fees and subsidies for additional services. The Agreement also provides for increased support for GPs in disadvantaged urban areas, and for improvements to maternity and paternity leave arrangements. 

The number of GPs entering training has increased steadily over the past number of years, from 120 in 2009 to 233 trainees enrolled this year. Further increases are expected following the transfer of responsibility for training from the HSE to the Irish College of General Practitioners. 

GP out of hours service providers play a key role in the delivery of our health service, providing GP care to patients in the community outside of normal GP surgery hours. In recognition of the challenges arising from the Covid-19 pandemic, and to ensure continuity of the service, a financial and service stability arrangement for GP out of hours co-operatives was introduced with effect from 14th March 2020. Under this measure some 14 GP out of hours co-ops are availing of the funding support measure, which has been extended further.

General Practitioner Services

Question No. 187 answered with Question No. 166.

Questions (186)

Cathal Crowe

Question:

186. Deputy Cathal Crowe asked the Minister for Health if his Department will support and fund a more expansive ShannonDoc service in County Clare. [59199/21]

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Written answers (Question to Health)

Funding is provided to Out of Hours service providers through service level agreements with the HSE. In relation to the funding allocated to ShannonDoc, as the HSE has responsibility for determining the allocation of funding from its budget, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Question No. 187 answered with Question No. 166.

Care of the Elderly

Questions (188)

Brian Stanley

Question:

188. Deputy Brian Stanley asked the Minister for Health his short- term and long-term plans for day care facilities for the elderly for County Laois. [59223/21]

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Written answers (Question to Health)

As this is an operational matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible

Hospital Services

Questions (189)

Colm Burke

Question:

189. Deputy Colm Burke asked the Minister for Health the action that has been taken to increase the number of hospital beds available in the South Southwest HSE area in view of the fact that there are 200 less beds available compared to January 2020; and if he will make a statement on the matter. [59356/21]

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

Awaiting reply from Department.

Questions (190)

Bernard Durkan

Question:

190. Deputy Bernard J. Durkan asked the Minister for Health his plans to isolate the new Covid-19 virus originating in Africa and South Africa; the extent to which plans are being put in place to use every possible means to combat its progress; if new medicine is likely to become available to deal with the issue; and if he will make a statement on the matter. [59364/21]

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Awaiting reply from Department.

Nursing Homes

Questions (191)

John Lahart

Question:

191. Deputy John Lahart asked the Minister for Health the status of a nursing home (details supplied); and if he will make a statement on the matter. [59233/21]

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Written answers (Question to Health)

On Monday the 20th of September, I had a productive visit to the site at Crooksling and met with officials from the HSE and a group of local representatives.  No formal decision has been reached on the future of the site of the former nursing home. However, my department will continue to engage in discussions to progress plans for the site.

Abortion Services

Questions (192)

Joan Collins

Question:

192. Deputy Joan Collins asked the Minister for Health if he will action a series of matters (details supplied) in relation to the legally mandated abortion review. [59220/21]

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Written answers (Question to Health)

The Health (Regulation of Termination of Pregnancy) Act 2018 was signed into law on 20 December 2018 and commenced on 1 January 2019. Under section 7 of the 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.  

Upon completion, a full report with any necessary recommendations will be submitted to me, as Minister, for consideration

Primary Care Services

Questions (193)

Jackie Cahill

Question:

193. Deputy Jackie Cahill asked the Minister for Health if he will report on the primary care psychology waiting list reduction initiative; and if he will make a statement on the matter. [59352/21]

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Written answers (Question to Health)

The Primary Care Psychology Waiting List Initiative was implemented to target a reduction in the number of children and young people under the age of 18 who are waiting more than 12 months to access primary care psychology services. 

Measures being implemented include the provision of overtime/increased hours where appropriate; the use of private capacity; arrangement of initial screening and/or once-off brief therapeutic appointments to supply clients with support/information; re-prioritisation of clients etc.

Significant progress has already been made since the commencement of this initiative, with the latest updates (end October 2021) demonstrating that the number of these clients waiting for over a year has reduced by 1026 (19%) compared to March 2021.

Hospital Facilities

Questions (194)

Éamon Ó Cuív

Question:

194. Deputy Éamon Ó Cuív asked the Minister for Health the planned programme for the commencement of construction for the provision of new buildings at Galway University Hospital over the next five years; the services that will be provided from these new buildings when complete; if these proposed buildings will be located on the Newcastle Road site or the Merlin Park site; the additional beds that will be involved; and if he will make a statement on the matter. [58582/21]

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Written answers (Question to Health)

As the Health Service Executive is responsible for the delivery of public healthcare infrastructure projects, I have asked the HSE to respond to you directly in relation to this matter.

Health Services

Questions (195)

James O'Connor

Question:

195. Deputy James O'Connor asked the Minister for Health his plans to expand neuro-rehabilitation services in Cork; his further plans to provide additional in-patient beds; and if he will make a statement on the matter. [59109/21]

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.

Mental Health Services

Questions (196)

Joe Flaherty

Question:

196. Deputy Joe Flaherty asked the Minister for Health the number of dementia advisers currently in place; the number that are to be recruited in 2022; and if he will make a statement on the matter. [59354/21]

View answer

Written answers (Question to Health)

As Minister of State with responsibility for Mental Health and Older People, I have long been a supporter of the dementia advisor service. In line with the Programme for Government, an additional 10 dementia advisors were recruited in 2020.  In 2021, I secured additional funding of €0.9 million for a further 11 posts for the dementia advisor service.

I was delighted to launch the expansion of the service on the 10th November. This recent expansion has enabled the service to be provided on a nationwide basis. It brings the total number of dementia advisor posts to 28 nationally along with a dementia co-ordinator post. All dementia advisors posts are expected to be filled by year end, with 25 of these posts already in place.  

Building on the investment made in 2021 for dementia services, I secured an additional €7.3 million for dementia services and supports as part of Budget 2022. In addition, the proportion of new home-support hours that will be ring-fenced for people with dementia will more than double from 5% in 2021 to 11% in 2022. Taken together this will represent €15 million of increased investment in dementia in 2022.   

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. 

Disability Services

Questions (197)

Pauline Tully

Question:

197. Deputy Pauline Tully asked the Minister for Health the achievements to date in relation to the transfer of persons with disabilities under the age of 65 years who have been inappropriately placed in nursing homes back into the community; and if he will make a statement on the matter. [59473/21]

View answer

Written answers (Question to Health)

While nursing homes can be an appropriate care option for younger people with a clinically assessed complex medical and social care requirement which cannot be supported in their own home, alternative solutions are needed for others to give them more independence and choice in their daily lives.

The Programme for Government is committed to providing a pathway to eliminate the practice of inappropriately accommodating young people with serious disabilities in nursing homes. €3m has been allocated for a HSE led pilot project this year to assist 18 people inappropriately placed in nursing homes to move to more appropriate housing options in the community.

I am advised by the HSE that 14 individuals have moved from nursing homes as of 30 November.  Work is ongoing with regard to a further 4 individuals.

Health Strategies

Questions (198)

Jennifer Murnane O'Connor

Question:

198. Deputy Jennifer Murnane O'Connor asked the Minister for Health if he will report on the revised Implementation Plan for the National Maternity Strategy. [59351/21]

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Written answers (Question to Health)

On November 19th, I welcomed the publication of the revised Implementation Plan for the National Maternity Strategy, covering the remaining period of the Strategy’s lifetime from 2021 to 2026.

In line with HIQA’s recommendation in its 2020 report into maternity services and considering experience and changes that have occurred since the launch of the National Maternity Strategy in 2016, the National Women & Infants Health Programme (NWIHP) revised the original National Maternity Strategy’s Implementation Plan. Significant progress has already been made in implementing the Strategy since its launch in 2016, including the development of the Supported Care Pathway, increased availability of community-based midwifery care and increased access to specialist medical services.

The revised Plan sets out in detail the roadmap to ensure the National Maternity Strategy is implemented in full within the timeframe originally intended. It presents clearly all outstanding actions, their status and the timeframe required for completion, all within the remaining period of the Strategy’s lifetime.

National Maternity Hospital

Questions (199)

Bríd Smith

Question:

199. Deputy Bríd Smith asked the Minister for Health if he will make a compulsory purchase order on the land owned by an organisation (details supplied) in which the new National Maternity Hospital is to be located; and if he will make a statement on the matter. [59468/21]

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Written answers (Question to Health)

The Government is committed to the development of the new National Maternity Hospital (NMH) planned for the St Vincent’s University Hospital Campus at Elm Park, as set out in the Programme for Government.

As the Deputy will be aware, the proposed corporate and clinical governance arrangements for the new National Maternity Hospital were set out in the Mulvey Agreement, which was finalised in 2016 following an extensive mediation process between the NMH and St. Vincent’s Healthcare Group (SVHG). The Mulvey Agreement provides for the establishment of a new company - National Maternity Hospital at Elm Park DAC - which will have clinical and operational, as well as financial and budgetary independence in the provision of maternity, gynaecology and neonatal services.

The draft legal framework that has been developed is designed to copperfasten these arrangements and to ensure protection of the State’s investment. Work is ongoing towards the finalisation of the legal arrangements.

I have been clear that I will not bring any proposal to Government unless it affirms that that State’s investment in the new hospital is safeguarded, as well as providing assurances around all legally permissible services being provided in the new NMH. However, as I have stated previously, I will not be making any further comment in relation to this matter until the process has concluded.

Eating Disorders

Questions (200)

Holly Cairns

Question:

200. Deputy Holly Cairns asked the Minister for Health the details of progress made in addressing the National Clinical Programme for Eating Disorders Goals 2021. [59345/21]

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.

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