Written Answers Nos. 1924-1944
1924. Deputy Ruairí Ó Murchú asked the Minister for Health when he expects the citizens' assembly on drugs to convene; if consideration has been given to convening this assembly in an online format; and if he will make a statement on the matter. [2469/22]
View answerConsideration is being given to the appropriate methodology for future citizens' assemblies, including one on drugs use. Decisions will be guided by the experience of the Gender Equality Assembly which completed earlier this year. An independent researcher was appointed by the Assembly to monitor and record, amongst other things, the perceived deliberative quality of the Assembly. This report, published in July 2021, will assist in decisions on future Assemblies use of virtual meetings.
By their very nature, citizens assemblies require large gatherings to be truly effective. Therefore, there has been an unavoidable delay in the establishment of the next citizens' assembly due to public health restrictions arising from the Covid-19 pandemic.
The Department of Health continues to liaise with the Department of the Taoiseach on the timing and format of the proposed citizen assembly on drug use. It is envisaged that the remaining citizen assembly, including the citizen assembly on drug use, will be established after the Dublin mayor citizens' assembly has completed its work. The specific timing of each assembly has yet to be confirmed.
The Department of Health's approach to the citizen assembly on drugs use will be informed by the Government's health-led approach to people who use drugs, as outlined in the national drugs strategy. An important component of the health-led approach is the Health Diversion Programme. The Health Diversion Programme offers compassion, not punishment, to people who use drugs and connects them with health services and provides a pathway to recovery, thereby avoiding a criminal conviction. As outlined in the Programme for Government, the programme will be reviewed after the first full year of implementation to ensure that it is meeting all of it aims and to make any necessary changes. This review could usefully inform the deliberations of the citizen's assembly on drug use.
A strategic priority for the implementation of the national drugs strategy for 2021-2025 is to promote alternatives to coercive sanctions for drug-related offences. This will include the exchange of best practice with EU member states, as part of the EU Drugs Strategy 2021 – 2025.
I believe that a citizen's assembly could usefully consider the learnings from the health diversion programme and other similar alternatives to coercive sanctions. It could also inform the development of the next national drugs strategy, to replace the existing strategy in 2025.
1925. Deputy Michael Healy-Rae asked the Minister for Health the steps being taken to provide a permanent full-time general practitioner in a village (details supplied) in County Kerry; and if he will make a statement on the matter. [2490/22]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1926. Deputy Matt Carthy asked the Minister for Health the dental services that are available to children and those under the age of 18 who are in receipt of a medical card; and if he will make a statement on the matter. [2558/22]
View answer1927. Deputy Matt Carthy asked the Minister for Health if his attention has been drawn to the fact that follow-up dental appointments for children in receipt of a medical card are not covered by the card; and if he will make a statement on the matter. [2559/22]
View answerI propose to take Questions Nos. 1926 and 1927 together.
Currently dental care for children under 16 is provided by the Public Dental Service of the HSE in accordance with 1994 Dental Health Action Plan, with a strong emphasis on prevention. This is delivered through targeted screening and prevention for school children at certain dental developmental milestones and for special needs groups. The HSE advise that children who are 16 or under have access to emergency treatment through the HSE. Particular treatment that needs to be resolved over several appointments is not considered as an emergency.
The Dental Treatment Services Scheme, 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. Patients may choose to have their treatment undertaken by any dentist who participates in the scheme. The Scheme covers a dental examination, two fillings in each calendar year, prescriptions, denture repairs and extractions as necessary. Other more complex treatments such as the provision of dentures require the approval of the HSE before the dentist can proceed and in this case the dentist applies directly to the HSE.
A new National Oral Health Policy 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.
Under the new Policy, all children up to 16 years will have available to them eight oral healthcare packages consisting of examinations, assessments (including orthodontic assessments), advice, prevention interventions, emergency care and referral as appropriate. The packages will be provided in a primary care setting by oral healthcare practitioners contracted by the HSE. The roll-out of these packages of care will take place incrementally.
1930. Deputy Holly Cairns asked the Minister for Health the status of the Bantry Hospital dental and orthodontic services; and if he will make a statement on the matter. [2598/22]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1931. Deputy Holly Cairns asked the Minister for Health the steps he is taking to provide medical treatment for persons diagnosed with Ehlers Danlos syndrome; and if he will make a statement on the matter. [2599/22]
View answerAs this P.Q. relates to a service matter it has been referred to the Health Service Executive for a direct reply.
1932. Deputy Holly Cairns asked the Minister for Health if he will revise the long-term illness scheme to cover persons diagnosed with Crohn's disease; and if he will make a statement on the matter. [2600/22]
View answerThe Long Term Illness (LTI) scheme was established under Section 59(3) of the Health Act 1970 (as amended). Regulations were made in 1971, 1973 and 1975, prescribing 16 illnesses covered by the scheme. These are: acute leukaemia; mental handicap; cerebral palsy; mental illness (in a person under 16); cystic fibrosis; multiple sclerosis; diabetes insipidus; muscular dystrophies; diabetes mellitus; parkinsonism; epilepsy; phenylketonuria; haemophilia; spina bifida; hydrocephalus; and conditions arising from the use of Thalidomide.
Under the LTI scheme, patients receive drugs, medicines, and medical and surgical appliances directly related to the treatment of their illness, free of charge. The LTI scheme will be included as part of a review of the current eligibility framework, including the basis for existing hospital and medication charges, to be carried out under commitments given in the Sláintecare Implementation Strategy.
In the meantime, for people who are not eligible for the LTI scheme, there are other arrangements which protect them from excessive medicine costs.
Under the Drugs Payment Scheme, no individual or family pays more than €100 a month towards the cost of approved prescribed medicines. The scheme significantly reduces the cost burden for families and individuals with ongoing expenditure on medicines.
People who cannot, without undue hardship, arrange for the provision of medical services for themselves and their dependants may be eligible for a medical card. In accordance with the provisions of the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE. In certain circumstances the HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income guidelines, where he or she faces difficult financial circumstances, such as extra costs arising from illness.
In circumstances where an applicant is still over the income limit for a medical card, they are then assessed for a GP visit card, which entitles the applicant to GP visits without charge.
Persons may also be entitled to claim tax relief on the cost of their medical expenses, including medicines prescribed by a doctor, dentist, or consultant. Relief is at the standard tax rate of 20%.
1933. Deputy Holly Cairns asked the Minister for Health the longest waiting-time experienced by a CHO4 staff member to have a grievance hearing arranged for stage 1 of the HSE grievance procedure following submission of their formal grievance and for the arrangement of a stage 2 hearing following the completion of stage 1 in 2020 and 2021; and if he will make a statement on the matter. [2601/22]
View answerI have asked the HSE to respond directly to the Deputy on this matter.
1934. Deputy Holly Cairns asked the Minister for Health the details including the location of the service, the date of appointment and contract type, that is, permanent or fixed term of appointments to HSE adult mental health psychology posts that were not subject to a competition process from January 2014 until December 2021 in CHO4 (details supplied); the reason in each instance a competition process involving eligible candidates did not take place; and if he will make a statement on the matter. [2602/22]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
1936. Deputy Holly Cairns asked the Minister for Health the steps he is taking to ensure adequate HSE dental appointments are available to children in south-western areas of County Cork. [2604/22]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1937. Deputy Holly Cairns asked the Minister for Health if all student occupational therapists, speech and language therapists and radiology students will be paid for the work they do in hospital and healthcare settings as part of mandatory placements; and if he will make a statement on the matter. [2605/22]
View answerAcross the health and social care disciplines, there are approximately 7,330 Health and Social Care Professional students in training who will, at different stages, require clinical placement in hospital and healthcare settings. The length of placements and the activities performed during these placements varies between disciplines. Students are not employees and in many cases the nature of the placement is in an observing and a learning capacity. This is a key part of the learning in all undergraduate programs.
There are only a small number of healthcare courses where the students receive allowances to support clinical placements during training. These allowances have been in place for a number of years and based on specific requirements of the individual training program. Occupational Therapy, Speech and Language Therapy and Radiography students similar to many other healthcare students do not receive an allowance to support time spent on clinical placements as part of their training.
Student Nurses and Midwives are an example of undergraduate students that do get support in the form of allowances associated with some clinical placements. The clinical hours component of undergraduate training for nurses and midwives is almost 50% of the course. Student nurses and midwives must undertake placements across a wide variety of care areas to fulfil course requirements and often these placements are away from their normal place of residence. In these instances, travel to, and alternative and additional accommodation to normal place of residence is required for a number of weeks. This is supported by an allowance towards the cost of additional accommodation. Additional support is being provided to student nurses and midwives needing overnight accommodation away from their normal place of residence in order to attend some of their clinical placements. This is a vouched system of support in place since 2004 and only applicable for some clinical placements.
1938. Deputy Holly Cairns asked the Minister for Health his views on putting in place the resources to extend the medical assessment unit opening hours in Bantry General Hospital to a 24/7 basis; and if he will make a statement on the matter. [2606/22]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
1939. Deputy Cathal Crowe asked the Minister for Health the status of mop-up clinics for those who have missed out on the HPV vaccine in first year of school for any given reason but wish to avail of it in subsequent school years. [2631/22]
View answerThe immunisation programme in Ireland is based on the advice of the National Immunisation Advisory Committee (NIAC). The committee's recommendations are based on the prevalence of the relevant disease in Ireland and international best practice in relation to immunisation. It makes recommendations on vaccination policy to my Department. The NIAC continues to revise recommendations to allow for the introduction of new vaccines in Ireland and to keep abreast of changes in the patterns of disease. Therefore, the immunisation schedule will continue to be amended over time.
In 2009, the NIAC recommended HPV (human papillomavirus) vaccination for all 12 to 13 year old girls to reduce their risk of developing cervical cancer when they are adults. In September 2010, the HPV vaccination programme was introduced for all girls in first year of secondary school.
In June 2017, on foot of the NIAC’s recommendation that the HPV vaccine should also be given to boys, my Department asked the Health Information and Quality Authority (HIQA) to undertake a health technology assessment (HTA) to establish the clinical and cost-effectiveness of extending the immunisation programme to include boys in the first year of secondary school.
The HIQA completed the HTA in December 2018, recommending that the HPV immunisation programme be extended to include boys. A policy decision was made to extend the HPV immunisation programme to include boys, starting in September 2019, with the introduction of a 9-valent HPV vaccine.
The ages at which vaccines are recommended in the immunisation schedule are chosen by the NIAC in order to give each child the best possible protection against vaccine preventable diseases. As the HPV vaccine is preventative it is intended to be administered, if possible, before a person becomes sexually active, that is, before a person is first exposed to HPV infection.
Therefore, the gender-neutral HPV vaccination programme targets all girls and boys in first year of secondary school to provide maximum coverage. All vaccines administered through the School Immunisation Programme are provided free of charge.
My Department will continue to be guided by NIAC's recommendations on any emerging evidence on this issue in the future.
Anyone not in 1st year of secondary school or age equivalent in special schools or home schooled during the 2021/2022 school year who wishes to get the HPV vaccine, must go to their GP or sexual health clinic and pay privately for the vaccine and its administration. This applies to everyone whether or not they have a medical card/GP visit card, as it is outside of the HPV immunisation programme.
My Department has asked the National Immunisation Advisory Committee to consider the clinical effectiveness of providing the HPV vaccine to:
- girls and boys in secondary school who were eligible to receive HPV vaccine in 1st year but who did not receive it; and
- women up to the age of 25 years who have left secondary school and who did not receive the vaccine when eligible.
If the NIAC conclude that there is sufficient evidence to support providing the HPV vaccine to one or both groups, HIQA will undertake a cost-effectiveness assessment on that basis.
1940. Deputy Richard Boyd Barrett asked the Minister for Health the total cost to the Exchequer from the beginning of the Covid-19 pandemic to date of arrangements made with private hospitals and private health providers for use of private hospitals and healthcare capacity to deal with Covid-19 and non-Covid care during the pandemic; if he will provide as much detail as possible in relation to the conditions of these various deals; the projected cost during the coming period while these arrangements continue; and if he will make a statement on the matter. [2633/22]
View answerThe original arrangement with the private hospitals ran from April – June 2020, where, by way of Government Decision, the HSE acquired access to the totality of private hospital capacity. Under this arrangement, all 18 private hospitals signed up to centrally negotiated Heads of Terms and 100% of their capacity (including ICU) was made available to the State. Following the termination of this agreement in June 2020, the Government mandated the HSE to seek to agree with the private hospitals a new arrangement which would provide the HSE with access to private hospital capacity to include a safety net arrangement for any further surge of Covid-19 cases.
In January 2021 all 18 private hospitals signed a Safety Net 2 agreement to provide additional hospital capacity to the HSE to deal with the surge in Covid-19. The agreement is a standard agreement, signed individually between the HSE and the relevant private hospital/private hospital group. Under the agreement the HSE can obtain up to 15% or 30% of the private hospitals’ capacity, depending on certain metrics regarding the level of community transmission of the disease, or numbers hospitalised or in ICUs occurring. The agreement remains in place until between the middle or end of January 2022, depending on the hospital concerned. The arrangement provides that where the HSE invokes the agreement but does not use the full capacity sought it makes a payment for the unused capacity.
The HSE also made use of private hospital capacity, through a Safety Net 3 arrangement it made with the private hospitals, to help it deal with the cyber-attack which occurred in May 2021.
Actual payments made to the private hospitals under the Safety Net arrangements amounted to €288.2m in 2020 and €119.8m in 2021.
The HSE and the private hospitals have agreed an amended and extended Safety Net agreement, Safety Net 4, building on the lessons learnt from the operation of Safety Net agreements 2 and 3. The agreement will be submitted to Government shortly for its approval and if Government agrees to it, the details will be made available then.
1941. Deputy Róisín Shortall asked the Minister for Health the position for persons who suffered an adverse reaction to their first Covid-19 vaccination dose and who needed hospital treatment as a result; if such persons who have medical evidence, for example, from a consultant neurologist, recommending against taking a second vaccination dose will have provision made to allow attendance in a premises and or venue covered by the domestic Covid-19 certificate and also for the purposes of travelling abroad; and if he will make a statement on the matter. [2641/22]
View answerThe immunisation programme in Ireland is based on the advice of the National Immunisation Advisory Committee (NIAC). The Committee's recommendations are based on the prevalence of the relevant disease in Ireland and international best practices in relation to immunisation. It makes recommendations on vaccination policy to my Department.
The HSE has been advised to operationalise updated NIAC guidance in relation to the mixing of vaccines, specifically relating to certain people who are yet to complete a two-dose Covid-19 vaccine regimen.
The NIAC advice on heterologous vaccination relates to:
Individuals who have already had a first dose of Vaxzevria® (AstraZeneca) and who did not complete the vaccination schedule as recommended and have requested an mRNA second dose. If an mRNA vaccine is used as a second dose, it should be given after an interval of at least 28 days and the person should be considered fully vaccinated.
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.
It is important to note that the number of people with an absolute contraindication to Covid-19 vaccination is very small. There are very few people who cannot receive one of the current vaccines due to pre-existing allergies or history of anaphylaxis.
The current high level of Covid-19 infection 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. My Department is considering the issues arising for those people that cannot receive a Covid-19 vaccine for medical reasons.
1942. Deputy James Lawless asked the Minister for Health when the general practitioner visit card which was extended in Budget 2022 to children under eight years of age will commence; and if he will make a statement on the matter. [2645/22]
View answerThe Government is committed to increasing access to GP care without charges for children, an important healthcare measure that will remove a potentially prohibitive cost barrier to accessing GP care and will help to improve children’s health as they develop. At present all children up to and including the age of 5 are eligible for a GP visit card and therefore GP care without charges.
The Health (General Practitioner Service and Alteration of Criteria for Eligibility) Act 2020 provides, amongst other things, for the phased expansion of GP care without fees to all children aged 12 years and under in three phases: to children aged 6 and 7; to children aged 8 and 9; and to children aged 10,11 and 12. Budget 2022 provides for the initial stage of this phased expansion, the provision of GP care without fees to all children aged 6 and 7 and my Department has commenced work to roll the service out this year.
The specific date for commencing the expansion remains under consideration in light of COVID-19 and the additional pressures the expansion might place on general practice in that context and will require consultation with the IMO, representing General Practitioners. It is important to ensure that any additional pressures placed on general practice will not limit its capacity to meet the needs of all patients in the community.
1943. Deputy Peadar Tóibín asked the Minister for Health the number of persons who died by suicide in the State in each of the past ten years by county.; and if he will make a statement on the matter. [2646/22]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
1944. Deputy David Cullinane asked the Minister for Agriculture, Food and the Marine his views on issues raised in correspondence from a person (details supplied); and if he will make a statement on the matter. [62945/21]
View answerThroughout 2020, my Department met regularly with representatives of the aquaculture sector, to hear their views on the impact of the Pandemic on the sector and to discuss their submissions seeking financial supports. Many aquaculture producers had availed of the suite of Government Pandemic supports, but made a case for additional supports for lost sales and production.
Following discussions, in October 2020, I announced a Covid-19 Aquaculture Support Scheme under my Department's European Maritime and Fisheries Fund Programme, designed to compensate oyster and rope mussel producers for lost sales arising from the Pandemic. A total of 154 aquaculture producers benefited from supports under the scheme, with payments ranging from €6,800 to €16,300 for oyster producers and from €1,300 to €9,000 for rope mussel producers.
Payments varied according to historic production levels of the producers concerned. I am advised by BIM that the individual identified by the Deputy did not apply under the scheme.
In relation to matters raised by the Deputy concerning site 22 at Dunmore East Fishery Harbour Centre, officials from my Department met with the company concerned on 12 August 2021. Proposals were subsequently received by my Department on 9th December 2021, which set out matters that my Department had already identified would not be suitable to resolve this situation. Substantive proposals from the company are awaited and the company in question has been advised in this regard.
