Written Answers Nos. 503-525
505. Deputy Pauline Tully asked the Minister for Health if he plans to provide funding to alleviate the pressure on Temple Street and Crumlin Hospitals as per the request submitted by Children’s Health Ireland; and if he will make a statement on the matter. [59896/21]
View answerI acknowledge that waiting times for many hospital procedures and appointments are unacceptably long. It is of particular regret that children can experience long waiting times for orthopaedic treatment, especially for time sensitive procedures, and I remain acutely aware of the impact that this has on children and their families. As part of Children’s Health Ireland’s (CHI) paediatric orthopaedic service, most scoliosis cases are treated at Crumlin and Temple Street, with Crumlin providing specialised multi-disciplinary treatment for the most complex patients. The National Orthopaedic Hospital at Cappagh provides additional capacity for the treatment of less complex orthopaedic patients, including routine scoliosis procedures. By using the capacity provided by Cappagh, CHI can free up space in order that complex orthopaedic procedures, including scoliosis spinal fusions, can be carried out centrally at CHI sites.More specifically, additional theatre capacity at the National Orthopaedic Hospital Cappagh commenced on the 26 April 2021 for daycase surgery. CHI has advised the Department of Health that this should result in a positive impact in reducing long waiting times for general orthopaedics, in addition to consequential capacity gains for scoliosis patients. In 2022 CHI is planning to undertake a range of inpatient, daycase and outpatient orthopaedic appointments in Cappagh.In 2018 Children’s Health Ireland was provided with an additional €9 million in funding to address paediatric orthopaedic waiting lists, including the provision of scoliosis services. This funding is recurring and has been provided in the base HSE allocation each year since 2018. The additional funding supported the recruitment of approximately 60 WTEs in 2018 and 2019 to enable the expansion of paediatric orthopaedic services. Funding proposals submitted to the HSE by Children’s Health Ireland for increased investment in paediatric orthopaedic services in 2022 will be decided as part of the finalisation of the Access to Care fund. In addition the HSE has advised my Department that a proposal to fund an additional theatre at Temple Street is currently progressing through the normal HSE capital approval process. Improving access to scheduled care capacity remains a priority for me and my Department as we work to finalise next years’ Access to Care fund.Improving waiting times for hospital appointments and procedures remains a commitment of this Government. For 2022 an additional allocation of €250 million, comprised of €200 million to the HSE and €50 million to the National Treatment Purchase Fund has been provided in respect of work to reduce hospital and community waiting lists. The €250 million will be used to fund additional activity in both the public and private sectors. The €50 million additional funding provided to the NTPF brings its total allocation for 2022 to €150 million, and as a consequence there will be a budget of €350 million available to support vital initiatives to improve access to acute hospitals and community health services.In addition, my Department, the HSE and the NTPF are working on a Multi Annual Waiting List Plan. This process will be overseen by a Ministerial Taskforce, chaired by the Secretary General of my Department and includes representatives from the HSE and National Treatment Purchase Fund. The plan will be informed by the lessons learned from the successful Vaccine Taskforce.
506. Deputy Mairéad Farrell asked the Minister for Health the number of protected disclosures made to him concerning his Department and bodies under its aegis in 2018, 2019 and 2020. [59914/21]
View answerPlease refer the table.
|
Year |
Number of Disclosures received |
|
2018 |
23 |
|
2019 |
5 |
|
2020 |
10 |
507. Deputy Verona Murphy asked the Minister for Health the number of dentists in County Wexford who were contracted with the HSE under the dental treatment services scheme who have left the scheme in the past 24 months; and if he will make a statement on the matter. [59926/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
508. Deputy Brendan Howlin asked the Minister for Health if his attention has been drawn to the long waiting list for neurology patients at St. Vincent’s University Hospital, Dublin; if his attention has been further drawn to the acute shortage of neurology nurse specialists at the hospital; his plans to address this issue; and if he will make a statement on the matter. [59928/21]
View answerIt is recognised that waiting times for scheduled appointments and procedures have been impacted in the last twenty months as a direct result of the COVID-19 pandemic. While significant progress was made in reducing waiting times from June 2020 onwards, the surge in Covid-19 cases in the first quarter of 2021 and the associated curtailment of acute hospital services, coupled with the ransomware attack of May 2021, has impacted waiting times.
The current surge in Covid-19 cases has put increasing pressures on hospitals and ICUs. As part of the response to this the HSE advised all Hospital Groups on 18th November, to take a series of immediate actions which include a 14 day period of prioritising unscheduled care, COVID care and time sensitive work in particular in Model 4 hospitals. The situation is to be reviewed after that period.
On the 7th October I published the Acute Waiting List Action Plan. This plan, to run until December 2021, has a series of targeted measures that are designed to address the growth in waiting lists caused by Covid-19 and the cyber-attack. In addition, my Department, the HSE and the NTPF are also working on a Multi Annual Waiting List Plan to bring waiting lists in line with Sláintecare targets over the coming years. This process will be overseen by a Ministerial Taskforce, chaired by the Secretary General of my Department and includes representatives from the HSE and National Treatment Purchase Fund. The plan will be informed by the lessons learned from the successful Vaccine Taskforce.
For 2022 an additional allocation of €250 million, comprised of €200 million to the HSE and €50 million to the National Treatment Purchase Fund has been provided in respect of work to reduce hospital and community waiting lists. The €250 million will be used to fund additional activity in both the public and private sectors. The €50 million additional funding provided to the NTPF brings its total allocation for 2022 to €150 million, and as a consequence there will be a budget of €350 million available to support vital initiatives to improve access to acute hospitals and community health services.
Additionally, the NTPF have advised my department that they have also approved an outpatient neurology initiative for funding at St Vincent’s University Hospital, which will facilitate treatment for 650 patients on neurology waiting lists.
In relation to the particular query raised, concerning the acute shortage of neurology nurse specialists at St Vincent’s University hospital, as this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
509. Deputy Brendan Smith asked the Minister for Health the level of funding to be provided by his Department in 2022 for the promotion and support of the social enterprise sector; and if he will make a statement on the matter. [59939/21]
View answerThe Department does not fund any social enterprises directly but that the Health Act 2004 does allow the HSE to contract services from voluntary providers via service level agreements under Section 38 and Section 39 of the Act. Each year in an appendix to their financial statements the HSE details the funding allocated to outside agencies. I have detailed below the allocations for the years 2018 to 2020 and although the numbers include an element of for-profit organisations it is primarily directed to voluntary bodies, including both national and local Section 38 and Section 39 providers.
As the 2021 financial statements are not due to be published until May 2022, and the 2022 allocation is a function of the 2022 national service plan which is underway but still to be finalised, I am referring this PQ to the HSE for further comment.
Total Revenue and Capital Grants to Outside Agencies
2018 €4,463,755,000
2019 €5,024,306,000
2020 €5,802,552,000
Link to the HSE Annual Reports and Financial Statements
www.hse.ie/eng/services/publications/corporate/annualrpts.html
510. Deputy Alan Farrell asked the Minister for Health the number of speech and language therapists and occupational therapists who were successfully recruited in 2020 and to date in 2021; and if he will make a statement on the matter. [59953/21]
View answer512. Deputy Alan Farrell asked the Minister for Health the way the HSE manage cases assigned to speech and language therapy and occupational therapists when they need to take maternity cover or have a long-term absence; and if he will make a statement on the matter. [59955/21]
View answerI propose to take Questions Nos. 510 and 512 together.
As these are service matters, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
511. Deputy Alan Farrell asked the Minister for Health if the HSE is actively recruiting paediatric rheumatologists to improve services to children who need their expertise; and if he will make a statement on the matter. [59954/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
513. Deputy Alan Farrell asked the Minister for Health if the HSE has a plan to extend the role of the clinical nurse specialist for Down's syndrome patients to regions outside of Leinster; and if he will make a statement on the matter. [59956/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
514. Deputy Alan Farrell asked the Minister for Health the status of the introduction of a statutory right to homecare which is included in the Sláintecare action plan for 2021; and if he will make a statement on the matter. [59958/21]
View answerThe Sláintecare Implementation Strategy & Action Plan 2021-2023 commits the State to reforms that will allow people to access health care in a timely manner and as close to their own homes as is safely possible. The development of a new statutory scheme for the financing and regulation of home-support services is part of these reforms.
The Action Plan states that in the first half of 2021, the Department of Health should work on advancing and continuing the development of the scheme. This work, which is ongoing, encompasses the development of the regulatory framework for the new scheme; the examination of the options for the financing model for the scheme; and the development of a reformed model of service-delivery.
With the aim of ensuring that all service-users are provided with a standard, high-quality level of care which is safe, effective, and person-centred, it is envisaged that the regulatory framework will comprise: (i) primary legislation for the licensing of public and private home-support providers; (ii) minimum requirements (i.e., regulations); and (iii) HIQA National Standards for Home Support Services.
Earlier this year, Government gave approval to draft a General Scheme and Heads of a Bill to establish a licensing framework for home-support providers. This is being progressed by the Department with a view of bringing it through the Houses of the Oireachtas at the earliest opportunity. It is expected that the primary legislation will give the Minister for Health the power to make regulations in respect of minimum requirements which will form the criteria against which a provider’s eligibility to hold a licence will be determined. The Department commenced a targeted stakeholder consultation on these draft minimum requirements. In addition, HIQA ran a public scoping consultation to inform the development of their National Standards for Home Support Services.
In relation to the development of a statutory scheme for the financing of home support, the Department is undertaking work on the potential demand for and cost of the introduction of a such a scheme.
The Action Plan states that in the second half of 2021, the Department of Health should work on commencing the implementation and evaluation of the reformed model of service delivery. Funding was secured for the Health Service Executive to: (i) progress the roll-out of interRAI as the standard assessment tool for care-needs in the community; (ii) pilot a reformed model of service-delivery for home-support; and (iii) establish a National Office for Home Support Services.
The testing of the reformed model of service delivery for home-support commenced in November 2021 in the first of the four pilot sites, CHO 8 (East Westmeath). It is envisaged that the three other sites in CHOs 2, 4 and 7 will be fully operational by January 2022. The recruitment of 130 posts funded for the national rollout of interRAI as the standard assessment tool for care-needs is scheduled to commence in this quarter. A National Home Support Office is in the process of being established. A comprehensive and robust operational model for the roll-out of the interRAI has been developed which will facilitate effective, efficient, fair and transparent care needs assessment and planning and appropriate service delivery. The interRAI outputs and pilot site evaluation will be critical to the development of the new home-support scheme.
The Action Plan states that the implementation of the home-support scheme will commence in 2022.
515. Deputy Alan Farrell asked the Minister for Health when pharmacists will be included in the roll-out of the Covid-19 booster vaccination programme; and if he will make a statement on the matter. [59959/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
516. Deputy Alan Farrell asked the Minister for Health if his Department is working on the implementation of the Assisted Decision-Making (Capacity) Act 2015; and if he will make a statement on the matter. [59961/21]
View answerThe Department of Children, Equality, Disability, Integration and Youth has overall policy responsibility for the Assisted Decision Making (Capacity) Act 2015, with the exception of Part 8 of the Act, which is the responsibility of my Department.
Part 8 of the Act provides a legislative framework for Advance Healthcare Directives (AHDs). An AHD is a statement made by a person with capacity setting out his or her will and preferences regarding treatment decisions that may arise in the future when he or she no longer has capacity. Work under Part 8 involves the preparation of draft codes of practice by a multidisciplinary working group, previously established, and submission of the draft codes to the Decision Support Service (DSS), following which a public consultation on the draft codes is to take place. The Director of the DSS has recently commenced this consultation. Once this process is complete, the final codes of practice can be published by the Director with my consent, in accordance with the process outlined in the Act. The Codes, when published, will assist stakeholders in implementing the provisions of Part 8.
517. Deputy Alan Farrell asked the Minister for Health if there is a plan for the HSE to offer autism spectrum assessments for adults who wish to be assessed later in life; and if he will make a statement on the matter. [59962/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
518. Deputy Cian O'Callaghan asked the Minister for Health if his attention has been drawn to the fact that elderly persons and persons with disabilities were left waiting outdoors for up to three and a half hours while queuing for their Covid-19 booster vaccine at the Citywest walk-in centre; the steps he will take to ensure this does not reoccur; and if he will make a statement on the matter. [59966/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
519. Deputy Catherine Murphy asked the Minister for Health if he will provide an update in respect of trials of ivermectin on critically ill Covid-19 patients here. [59975/21]
View answerThe Deputy is advised that, previously at the request of the NPHET, HIQA conducted a rapid evidence review to identify studies on the effectiveness of (i) pharmaceutical and (ii) non-pharmaceutical interventions, in the ambulatory setting, aimed at reducing progression to severe disease in individuals with confirmed or suspected COVID-19. This evidence review included a review of relevant studies in relation to Ivermectin.
As confirmed by HIQA’s COVID-19 Expert Advisory Group - www.hiqa.ie/sites/default/files/2021-02/Interventions-to-prevent-progression_Advice.pdf - evidence regarding the effectiveness of pharmaceutical treatments intended for systemic use, must be subject to the highest standards of rigour. Where a pharmaceutical intervention is recommended in the absence of appropriate supportive evidence, there is a significant potential for harm to the patient. Whereas this risk of harm may be justified in certain circumstances (e.g. the intervention poses minimal risk, or the setting involves patients with high potential to gain due to almost certain risk of severe adverse consequences in absence of any intervention) this is less likely to be the case in the setting of mild disease, where a great number of otherwise well patients would potentially receive the intervention.
HIQA has also advised my Department that several international health technology assessment or guideline development organisations have specifically reviewed the evidence to date on ivermectin in COVID-19 and have cautioned or advised against the use of ivermectin outside the setting of clinical trials on the basis of the current evidence. HIQA has also advised that the pharmaceutical company MSD (Merck, USA), which holds a license in the USA for the use of ivermectin as an antiparasitic agent, on 4th February 2021 published a statement including the following:
“It is important to note that, to-date, our analysis has identified:
- No scientific basis for a potential therapeutic effect against COVID-19 from pre-clinical studies;
- No meaningful evidence for clinical activity or clinical efficacy in patients with COVID-19 disease, and;
- A concerning lack of safety data in the majority of studies.
We do not believe that the data available support the safety and efficacy of ivermectin beyond the doses and populations indicated in the regulatory agency-approved prescribing information.”
Further research was undertaken by HIQA and updated advice was provided to the National Public Health Emergency Team: COVID-19 - Interventions and health related factors that prevent infection or minimise progression to severe disease - at its meeting of the 12 May 2021 and was published by HIQA on the 23 June 2021
www.hiqa.ie/sites/default/files/2021-06/Advice-to-NPHET_Interventions-to-prevent-COVID-19.pdf
One of the key findings of the review was that Ivermectin is not currently licensed for the treatment of COVID-19. From this evidence summary, there is currently insufficient information on whether it can be safely used to prevent or reduce the severity of COVID-19. Ivermectin should therefore not be used as prophylaxis outside well-designed, regulated clinical trials as the benefits and harms are not yet clear when taken in the context of COVID-19 treatment.
Low certainty or very low certainty evidence was identified in relation to a small number of interventions. However, HIQA noted the low quality of the evidence available including the high risk of bias, small sample sizes and short durations of follow-up different trials and advised that results from these studies should not be used to inform decision-making with respect to effectiveness.
HIQA’s overall finding was that there is currently insufficient evidence of either effectiveness or safety to support the use of any pharmaceutical intervention in the community setting to reduce the risk of progression to severe disease in patients who have been diagnosed with COVID-19 unless as part of an ongoing monitored clinical trial. Furthermore, no evidence was identified for the effectiveness or safety of any non-pharmaceutical intervention in the community setting.
I trust that the above information satisfactorily addresses your question.
520. Deputy Peadar Tóibín asked the Minister for Health if any of the PPE, ventilators and equipment purchased from China was deemed unfit for use or was not used for a different reason; and the amount of unused equipment, PPE and ventilators which are still in storage. [59979/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
521. Deputy Peadar Tóibín asked the Minister for Health the number of reserve HSE staff available to assist in nursing homes in the event of a Covid-19 outbreak in a nursing home; the number of reserves per county; and if the HSE is still in a position to provide emergency staffing supports to nursing homes. [59980/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
522. Deputy Peadar Tóibín asked the Minister for Health the number of persons who were tested for Covid-19 in pop-up testing centres since the start of the Covid-19 pandemic; and the breakdown per county. [59982/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
523. Deputy Michael Fitzmaurice asked the Minister for Health the number of persons reliant daily on wheelchairs for living purposes in Dublin, Connacht, Leinster, Munster and Ulster, respectively in tabular form; and if he will make a statement on the matter. [59985/21]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
524. Deputy David Cullinane asked the Minister for Health if he will address a matter raised in correspondence by person (details supplied) in relation to treatment at University Hospital Waterford; and if he will make a statement on the matter. [59998/21]
View answerAs this is a service matter i have referred this to the HSE for direct response
525. Deputy Sean Fleming asked the Minister for Health the arrangements in place for persons who cannot get vaccinated due to health issues but need a digital or other certificate to allow them to participate in activities; and if he will make a statement on the matter. [59999/21]
View answer591. Deputy Niamh Smyth asked the Minister for Health the provisions that can be made for a person (details supplied) by his Department when socialising; if any document can overcome this issue; and if he will provide advice on the issue. [60322/21]
View answerI propose to take Questions Nos. 525 and 591 together.
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 on 15 July, NIAC made a recommendation, which was endorsed by the Chief Medical Officer and accepted by the Minister for Health that while the preference was for homologous vaccination regimens (using the same vaccine as part of a two dose regime) that selective use of heterologous vaccination schedules (two different vaccines used as part of two dose regime) should be permitted where a second vaccine dose of a homologous regimen is contraindicated, irrespective of whether the first dose was an mRNA or adenoviral vector vaccine. NIAC in conjunction with the RCPI and the Irish Association of Allergy and Immunology have prepared a guide to aid vaccinators and other healthcare workers on how to advise allergic individuals in respect of receiving a COVID-19 vaccine, this guide is available here: rcpi-live-cdn.s3.amazonaws.com/wp-content/uploads/2021/08/FAQs-about-COVID19-Vaccines-and-Allergies_12August2021.pdf
