Written Answers Nos. 651-670
651. Deputy Colm Burke asked the Minister for Health the estimated timeframe for when the new outpatient ophthalmology services for the South/South West HSE area currently being developed in Ballincollig, County Cork to be fully operational; and if he will make a statement on the matter. [4352/22]
View answer652. Deputy Colm Burke asked the Minister for Health when the required funding will be made available to the South/South West HSE area to enable it to fully equip the new outpatient ophthalmology services currently being developed in Ballincollig, County Cork; and if he will make a statement on the matter. [4353/22]
View answerI propose to take Questions Nos. 651 and 652 together.
As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
653. Deputy David Cullinane asked the Minister for Health the work which has been conducted in relation to general practice and primary care policy for implementation of Sláintecare; and if he will make a statement on the matter. [4361/22]
View answerThe Oireachtas Committee on the Future of Healthcare set out in the Sláintecare Oireachtas Report their vision to deliver safe, quality health and social care services that meets the needs of the growing population. The vision of Sláintecare is to achieve a universal single-tier health and social care system, where everyone has equitable access to services based on need, and not ability to pay.
General practice policies central to the implementation of Sláintecare are the reform of the GMS GP contract and the roll out of a Chronic Disease Management (CDM) programme for GMS patients, and the move towards universal access to GP services without charges on a phased basis. The key primary care policy supporting the implementation of Sláintecare is the development of the Enhanced Community Care programme.
The 2019 GP Agreement helps to modernise and reform the GMS scheme, expanding services for patients and making general practice a more attractive career option for doctors. As part of the agreement, the CDM programme for type 2 diabetes, asthma, COPD, and cardiovascular disease, commenced in 2020 and will be fully rolled out by 2023. The CDM programme aims to bring the care for chronic disease further into the community and reduce hospital attendance by patients with the four conditions.
Furthermore, the Agreement includes a commitment to undertake a strategic review of GP services within the lifetime of the Agreement, to examine how best to ensure the provision of GP services in Ireland for the future. The outcome of this review will inform future contractual changes, with preparatory work for the review having begun this year.
A number of measures have been introduced in recent years to expand access to GP care without charges. For example, since 2015, all children under the age of 6 years and all persons aged 70 and over are now automatically eligible for a GP visit card and since 2018, all those in receipt of either a full or half-rate Carer's Allowance or Carer's Benefit are automatically eligible for a GP visit card. In addition, Budget 2022 provides for the initial stage of the planned expansion of GP care without fees to all children aged 12 years and under, the provision of GP care without fees to all children aged 6 and 7, and work has commenced to roll this service out in the course of 2022.
The Enhanced Community Care (ECC) programme involves the development of new models of care and service delivery, maximising effectiveness and with integration as a core value as identified by Sláintecare.
Service delivery will be re-orientated towards General Practice, primary care and community-based services with CHNs and Community Specialist Teams working in an integrated way with the National Ambulance Service and acute services to deliver end-to-end care, keeping people out of hospital and embracing a ‘home first’ approach. The utilisation of eHealth forms a central part of the ECC programme and is key to supporting integration of services.
The ECC’s various components can be summarised as encompassing six areas of action:
- Establishing CHNs to provide the foundation and organisational structure through which an integrated care system is provided locally based on population need and size.
- Implementing integrated care programmes for older people and chronic disease management;
- Expanding workforce and infrastructure capacity in the community through targeted application of resources to a defined population. The focus will be on implementing best practice models of care to demonstrate the delivery of specific outcomes and sustainable services, which can be scaled for full national implementation;
- Expanding the range of services available in the community;
- Developing working arrangements for staff and contracted professionals to enable the delivery of expanded services;
- Developing an enabling environment for joined-up community working including ICT, data, clinical governance, patient safety and quality operating frameworks and systems.
These policy aims clearly align with the principles set out in the Sláintecare report, as well as with best practice principles enunciated internationally by WHO among others.
654. Deputy David Cullinane asked the Minister for Health the strategic work which has been conducted to assess and plan for future staffing requirements, workload and demographic pressures in general practice and primary care; and if he will make a statement on the matter. [4362/22]
View answerThe Health Service Capacity Review 2018 estimated future capacity requirements in acute hospitals, primary care and in services for older persons (residential and homecare services) for the period to 2031. The analysis took account of current levels of demand and capacity, demographic and non-demographic factors that will drive future demand, and the potential impact that key system reforms can have on capacity needs.
“Projections of Expenditure for Primary, Community and Long-Term Care in Ireland, 2019–2035, based on the Hippocrates Model ” (July 2021) a research paper from the ESRI funded by the Department of Health, projects expenditure for most primary, community, and long-term health and social care services in Ireland for the years 2019–2035.
General Practitioners play an important role in the primary care system. Specific to general practice, the HSE National Doctor and Training publication Medical Workforce Planning Future Demand for General Practitioners 2015-2025 noted that to meet the demand for GPs that may be required by 2025, the State would require significant increases to the annual intake for GP postgraduate specialist training.
There has been a significant increase in the number of GPs entering training in recent years, up from 120 in 2009 to 233 in 2021, with large increases made in recent years. Further increases are expected following the transfer of responsibility for training from the HSE to the Irish College of General Practitioners.
The Government has undertaken several other measures to increase the attractiveness of general practice to prospective GPs. Under the 2019 GP Agreement investment in general practice is set to increase by approximately 40% (€210 million) between 2019 and 2023, providing for significant increases in capitation fees for participating GPs. Improvements to maternity and paternity leave arrangements have also been made, and supports introduced for rural practices and practices in areas of urban deprivation.
The 2019 GP Agreement also includes a commitment to undertake a strategic review of GP services within the lifetime of the Agreement, to examine how best to ensure the provision of GP services in Ireland for the future. The outcome of this review will inform future contractual changes.
655. Deputy David Cullinane asked the Minister for Health the work which has been done on costing options for universal general practice care and public primary care; and if he will make a statement on the matter. [4363/22]
View answerGMS contractors receive a range of capitation rates, fee per service payments and practice supports. Extending GP care without charges to all citizens who do not currently hold a medical card or GP visit card would encompass a further 2.92 million people approximately. It is not possible to definitively calculate the cost of universal GP care without charges given the wide range of payments and variables that have to be accounted for.
Such a calculation would require a complex and detailed modelling exercise to account for a range of demographic changes, future projections of service demands and variation in the number of GPs and the allowances that could be paid.
Additionally, the fees payable to GPs could only be determined following agreement with the IMO on the scope and content of the general practitioner service to be provided, as well as on the future of the various other supports provided to general practice. However, the 2019 IGEES paper "Costing Framework for the Expansion of GP Care" provides a cost estimate for universal free GP care and is available from igees.gov.ie/wp-content/uploads/2019/10/Costing-Framework-for-the-Expansion-of-GP-Care.pdf.
Over the last number of years, several pieces of detailed policy analysis have been undertaken to assess various aspects of expanding eligibility for near or full universal access to primary care and other care sectors and the associated additional costs for the Exchequer. These include the Expert Group Report on Resource Allocation and Financing of the Irish Health System (2010), the White Paper on Universal Health Insurance and Associated Costs (2015) the Committee on the Future of Healthcare Sláintecare Report (2018) and Universal GP Care in Ireland: Potential Cost Implications (2018).
656. Deputy David Cullinane asked the Minister for Health the compensation options he has explored for incentivising holders of existing consultant contracts to adopt the new Sláintecare public only contract; and if he will make a statement on the matter. [4367/22]
View answerThe Government is committed to introducing the Sláintecare Consultant Contract to hospital consultants in our health service at the soonest available opportunity. This Contract remains a key focus of the HSE and my Department, and it is intended that the Contract will be introduced following engagement with the representative bodies, the IMO and the IHCA, a process that is ongoing. As the talks process has not concluded, it would not be appropriate to make public details about them at this time, save to say that I and my officials remain committed to introducing a new contract as soon as practicable.
657. Deputy Niamh Smyth asked the Minister for Health if he will urgently review the maximum reimbursement levels for orthopaedic surgery under the Cross Border Directive; if his attention has been drawn to the fact that many families are getting into debt due to vast differences in price north and south of the Border for these procedures (details supplied); and if he will make a statement on the matter. [4377/22]
View answerThe Northern Ireland Planned Healthcare Scheme (NI PHS) has been in effective operation since 1 January 2021. This Scheme was introduced to mitigate the loss of access to care from private providers in Northern Ireland under the EU Cross Border Directive, which ceased to apply as a result of Brexit. The new scheme enables persons resident in the State to access and be reimbursed for private healthcare in Northern Ireland by the HSE, provided such healthcare is publicly available within Ireland.
Patients are required to pay upfront for treatment under the Northern Ireland Planned Healthcare Scheme and claim for reimbursement from the HSE. Such healthcare will be reimbursed at the cost of providing that treatment in the State or the cost of same in Northern Ireland, whichever is the lesser. It is important to note that reimbursement is confined to the costs of the care itself and does not include any additional costs, such as currency exchange, travel or accommodation costs, incurred by the patient. Patients are advised to contact the HSE CBD office directly for further information on individual applications for reimbursement under the NI Planned Healthcare Scheme. Contact details are available on the HSE CBD website.
659. Deputy Ruairí Ó Murchú asked the Minister for Health if he will address the omission of general practice nurses from the frontline worker pandemic bonus payment; and if he will make a statement on the matter. [4383/22]
View answerFirstly I would like to extend my sincere gratitude to all healthcare workers for their efforts during this most challenging period.
In recognition of the efforts of the general public, volunteers and all workers during the COVID-19 pandemic and in remembrance of people who lost their lives due to the COVID-19 pandemic, on Wednesday 19 January, the Government announced a once-off public holiday will take place on Friday 18 March 2022.
The Government also announced COVID-19 recognition payment for frontline public sector healthcare workers, to recognise their unique role during the pandemic. The payment of €1,000 will not be subject to income tax, USC, or PRSI. The measure will be ring fenced to staff ordinarily onsite in COVID-19 exposed healthcare environments within the period between 1 March 2020 and 30 June 2021.
Those public sector frontline healthcare workers eligible for the payment will be directly employed public health sector staff working in clinical settings. A pro-rata arrangement will apply for eligible part time staff / equivalents and supernumerary students who were required to perform training in clinical sites.
The Department of Health will also introduce a measure for making a similar payment to staff in private sector nursing homes and hospices that were affected by Covid-19.
I would like to assure the Deputy that work is underway to ensure fairness in the application of this measure as the Government intended.
The Department and the HSE are currently engaging in finalising arrangements to give effect to the Government announcement concerning the Recognition Payment. Full particulars, eligibility and terms and conditions that apply to this payment shall be made available shortly. It is important that this measure is applied fairly as intended and I welcome the work that is ongoing to ensure this is so.
There are many, many individuals in our country who did so much during the pandemic. I and the Government is sincerely grateful for this commitment but it is appropriate that these public sector frontline healthcare workers get particular recognition. They exposed themselves to particular COVID-19 risks that did not exist in other work environments or those working from home. I am also deeply appreciative of all those frontline workers who worked in our nursing homes and hospices during this pandemic and that they also get similar recognition.
Outside of the above recognition, the Government also notes that some private healthcare companies have recognised the work of their employees during the pandemic. I would encourage private healthcare companies that have not already done so to consider appropriate measures to recognise their own frontline workers for their work during this most trying period.
660. Deputy Ruairí Ó Murchú asked the Minister for Health if he has had engagements with general practice nurses on their exclusion from the frontline workers pandemic bonus payment; and if he will make a statement on the matter. [4384/22]
View answerFirstly I would like to extend my sincere gratitude to all healthcare workers for their efforts during this most challenging period.
In recognition of the efforts of the general public, volunteers and all workers during the COVID-19 pandemic and in remembrance of people who lost their lives due to the COVID-19 pandemic, on Wednesday 19 January last, the Government announced a once-off public holiday will take place on Friday 18 March 2022.
The Government also announced COVID-19 recognition payment for frontline public sector healthcare workers, to recognise their unique role during the pandemic. The payment of €1,000 will not be subject to income tax, USC, or PRSI. The measure will be ring fenced to staff ordinarily onsite in COVID-19 exposed healthcare environments within the period between 1 March 2020 and 30 June 2021.
Those public sector frontline healthcare workers eligible for the payment will be directly employed public health sector staff working in clinical settings. A pro-rata arrangement will apply for eligible part time staff / equivalents and supernumerary students who were required to perform training in clinical sites.
The Department of Health will also introduce a measure for making a similar payment to staff in private sector nursing homes and hospices that were affected by Covid-19.
I would like to assure the Deputy that work is underway to ensure fairness in the application of this measure as the Government intended.
No engagements between me or my officials has taken place with General Practice Nurses since this measure was announced.
The Department and the HSE are currently engaging in finalising arrangements to give effect to the Government announcement concerning the Recognition Payment. Full particulars, eligibility and terms and conditions that apply to this payment shall be made available shortly. It is important that this measure is applied fairly as intended and I welcome the work that is ongoing to ensure this is so.
There are many, many individuals in our country who did so much during the pandemic. I and the Government is sincerely grateful for this commitment but it is appropriate that these public sector frontline healthcare workers get particular recognition. They exposed themselves to particular COVID-19 risks that did not exist in other work environments or those working from home. I am also deeply appreciative of all those frontline workers who worked in our nursing homes and hospices during this pandemic and that they also get similar recognition.
Outside of the above recognition, the Government also notes that some private healthcare companies have recognised the work of their employees during the pandemic. I would encourage private healthcare companies that have not already done so to consider appropriate measures to recognise their own frontline workers for their work during this most trying period.
662. Deputy Pauline Tully asked the Minister for Health the reason there is upwards of a two-month delay in registering a birth in the register of births, deaths and marriages in County Cavan; his plans to address this delay; and if he will make a statement on the matter. [4392/22]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
663. Deputy Paul Kehoe asked the Minister for Health if funding or grants are available to help persons who need a permanent oxygen machine with the electricity costs of running oxygen machines required as part of their treatment; and if he will make a statement on the matter. [4394/22]
View answerThe Health Service Executive (HSE) advise that one Community Health Organisation (CHO) offers an electricity allowance to patients who suffer from Chronic obstructive pulmonary disease or similar illnesses.
CHO 9 (Dublin North, Dublin North Central) offers this allowance, which varies across the different Local Health Offices areas that comprise it, to medical card holders. The continued payment of this allowance is based on historic practices within those local areas. However, these local areas may adjust their practices in line with every other CHO across the country where such an allowance was discontinued many years ago.
For persons experiencing difficulty in paying their electricity costs, financial assistance may be available through the Supplementary Welfare Allowance (SWA) Scheme as administered by the Department of Social Protection. Further information on the type of SWA payments available can be found here: www.gov.ie/en/collection/d5554-supplementary-welfare-allowance/.
The list of local offices, from which Community Welfare Services officers can provide the best advice on the process for accessing this assistance, can be found here: www.gov.ie/en/collection/cb07d7-supplementary-welfare-allowance-swa-list-of-offices-administering-swa/.
664. Deputy Pa Daly asked the Minister for Health his position in relation to a drug (details supplied) and for the approval of the drug for use here; and if he will make a statement on the matter. [4397/22]
View answerThe Health Products Regulatory Authority (HPRA), which is the competent authority for medicinal products in Ireland, has advised that Cariban is currently not licensed for use in Ireland, but that two similar products, Xonvea (doxylamine 10 mg and pyridoxine 10 mg) and Navalem (doxylamine 10 mg and pyridoxine 10 mg), have been licensed for use in Ireland. However, the companies holding the authorisations/licences have not marketed the products in Ireland to date, and the HPRA cannot compel a company to market a medicinal product.
To be considered for a license in Ireland, the company marketing the product would need to make an application to the HPRA. After a thorough evaluation of all the supporting evidence, and if the benefits of the product outweigh the known and potential risks, a license may be issued.
Where a medicine is not authorised in Ireland, a licensed wholesaler may import it if it has been prescribed by a doctor for a patient under his/her care, on his/her direct responsibility, and to meet the specific needs of a patient. The decision to prescribe or not prescribe any treatment for an individual patient is a decision for the treating clinician, in consultation with their patient.
The responsibility for the clinical use of unlicensed medicines lies with the prescriber. In accordance with the Medical Council’s Guide to Professional Conduct and Ethics, medical practitioners must ensure as far as possible that any treatment, medication or therapy prescribed for a patient is safe, evidence-based and in the patient’s best interests. This applies equally to licensed and unlicensed medicinal products.
665. Deputy Cathal Crowe asked the Minister for Health if section 39 healthcare workers will be entitled to the pandemic payment bonus; and if he will make a statement on the matter. [4398/22]
View answerFirstly I would like to extend my sincere gratitude to all healthcare workers for their efforts during this most challenging period.
In recognition of the efforts of the general public, volunteers and all workers during the COVID-19 pandemic and in remembrance of people who lost their lives due to the COVID-19 pandemic, on Wednesday 19 January, the Government announced a once-off public holiday will take place on Friday 18 March 2022.
The Government also announced COVID-19 recognition payment for frontline public sector healthcare workers, to recognise their unique role during the pandemic. The payment of €1,000 will not be subject to income tax, USC, or PRSI. The measure will be ring fenced to staff ordinarily onsite in COVID-19 exposed healthcare environments within the period between 1 March 2020 and 30 June 2021.
Those public sector frontline healthcare workers eligible for the payment will be directly employed public health sector staff working in clinical settings. A pro-rata arrangement will apply for eligible part time staff / equivalents and supernumerary students who were required to perform training in clinical sites.
The Department of Health will also introduce a measure for making a similar payment to staff in private sector nursing homes and hospices that were affected by Covid-19.
I would like to assure the Deputy that work is underway to ensure fairness in the application of this measure as the Government intended. The Department and the HSE are currently engaging in finalising arrangements to give effect to the Government announcement concerning the Recognition Payment. Full particulars, eligibility and terms and conditions that apply to this payment shall be made available shortly. It is important that this measure is applied fairly as intended and I welcome the work that is ongoing to ensure this is so.
There are many, many individuals in our country who did so much during the pandemic. I and the Government is sincerely grateful for this commitment but it is appropriate that these public sector frontline healthcare workers get particular recognition. They exposed themselves to particular COVID-19 risks that did not exist in other work environments or those working from home. I am also deeply appreciative of all those frontline workers who worked in our nursing homes and hospices during this pandemic and that they also get similar recognition.
Outside of the above recognition, the Government also notes that some private healthcare companies have recognised the work of their employees during the pandemic. I would encourage private healthcare companies that have not already done so to consider appropriate measures to recognise their own frontline workers for their work during this most trying period.
668. Deputy Joe McHugh asked the Minister for Health if he plans to widen the parameters of the once-off €1,000 pandemic payment to other healthcare groups and to persons who have worked on the front line since early 2020 and right through the pandemic; if his attention has been drawn to the enormous contribution and sacrifices made by carers and health practice nurses and the additional voluntary work carried out at vaccine centres by practice nurses; and if he will make a statement on the matter. [4410/22]
View answerFirstly I would like to extend my sincere gratitude to all healthcare workers for their efforts during this most challenging period.
In recognition of the efforts of the general public, volunteers and all workers during the COVID-19 pandemic and in remembrance of people who lost their lives due to the COVID-19 pandemic, on Wednesday 19 January, the Government announced a once-off public holiday will take place on Friday 18 March 2022.
The Government also announced COVID-19 recognition payment for frontline public sector healthcare workers, to recognise their unique role during the pandemic. The payment of €1,000 will not be subject to income tax, USC, or PRSI. The measure will be ring fenced to staff ordinarily onsite in COVID-19 exposed healthcare environments within the period between 1 March 2020 and 30 June 2021.
Those public sector frontline healthcare workers eligible for the payment will be directly employed public health sector staff working in clinical settings. A pro-rata arrangement will apply for eligible part time staff / equivalents and supernumerary students who were required to perform training in clinical sites.
The Department of Health will also introduce a measure for making a similar payment to staff in private sector nursing homes and hospices that were affected by Covid-19.
I would like to assure the Deputy that work is underway to ensure fairness in the application of this measure as the Government intended.
The Department and the HSE are currently engaging in finalising arrangements to give effect to the Government announcement concerning the Recognition Payment. Full particulars, eligibility and terms and conditions that apply to this payment shall be made available shortly. It is important that this measure is applied fairly as intended and I welcome the work that is ongoing to ensure this is so.
There are many, many individuals in our country who did so much during the pandemic. I and the Government is sincerely grateful for this commitment but it is appropriate that these public sector frontline healthcare workers get particular recognition. They exposed themselves to particular COVID-19 risks that did not exist in other work environments or those working from home. I am also deeply appreciative of all those frontline workers who worked in our nursing homes and hospices during this pandemic and that they also get similar recognition.
Outside of the above recognition, the Government also notes that some private healthcare companies have recognised the work of their employees during the pandemic. I would encourage private healthcare companies that have not already done so to consider appropriate measures to recognise their own frontline workers for their work during this most trying period.
669. Deputy Emer Higgins asked the Minister for Health the reason that children under four years of age that are consistently testing negative for Covid-19 on and antigen test three days in a row and are asymptomatic for a further 48 hours are not permitted to finish restricting their movements as is the case with children over four years of age; and if he will make a statement on the matter. [4423/22]
View answerThe Deputy may wish to note that as part of the HSE's public health guidance, antigen testing for children under the age of 4 has not been recommended.
Any child experiencing symptoms of COVID-19 should isolate from other people (stay at home) and seek a test according to the guidance available on the HSE website which depends on the age and individual circumstances of the child. If the child gets a negative PCR result, they can stop isolating 48 hours after they have no symptoms. If the child gets a positive result, they should continue to self-isolate until both of these apply:
- they have not had a high temperature (38 degrees Celsius or over) or other symptoms for 48 hours AND
- it has been 7 days since they first developed symptoms
In cases where a child is a close contact of a person who tested positive for COVID-19, the guidance applicable, including any requirements in relation to testing, will depend on the age and individual circumstances of the child. In the case of a child aged three and under who is a close contact and who does not have symptoms, they do not need to be tested but they should restrict movements for seven days.
Comprehensive guidance applicable to the circumstances described in the question is available on the HSE website at www2.hse.ie/conditions/covid19/.
The evidence relating to the detection of COVID-19, and the actions deemed appropriate to mitigate the impact of the virus across the population, are kept under continuing review by the National Public Health Emergency Team (NPHET) and the Department of Health. The measures in place will continue to be adapted to the epidemiological profile of the disease, its impact on healthcare utilisation and outcomes, the vaccination status of the population and ECDC guidance.
670. Deputy Carol Nolan asked the Minister for Health the reason the Council of Europe Convention against Trafficking in Human Organs of 25 March 2015 has not been signed; the necessary legislative or administrative measures required to implement the Convention; and if he will make a statement on the matter. [4426/22]
View answerIreland signed the Council of Europe Convention against Trafficking in Human Organs on 8 October 2015, and thereby signaled its intention to adhere to the provisions pending the development of the necessary legislation to give effect to the Convention.
Ireland will only be in a position to ratify the Convention when the necessary legislation is in place. The enactment of the Human Tissue (Transplantation, Post-Mortem, Anatomical Examination and Public Display) Bill is a priority for the Government. Work on the drafting of the Bill in collaboration with the Office of Parliamentary Council is progressing with a view to ensuring that Government approval is secured to publish the Bill during the Spring legislative session. This proposed legislation will, among other things, prohibit the commercialisation of human organs and tissue for transplantation and the trafficking of organs for transplantation.
In addition, the European Union (Quality and Safety of Human Organs intended for Transplantation) Regulations 2012 which transpose Directive 2010/53/EU provide that a person who procures or sells, including brokering the procurement or sale, for exchange of money or value an organ contrary to the Regulations and the Directive, is guilty of an offence.
