Written Answers Nos. 771-790
771. Deputy Colm Burke asked the Minister for Health the number of primary care centres that have been developed to completion in 2019, 2020 and to 31 December 2021, in tabular form; and if he will make a statement on the matter. [5000/22]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
772. Deputy Colm Burke asked the Minister for Health if his Department is on target in delivering additional primary care centres for 2022; the number of additional primary care centres that will be fully operational by Q4 2022; and if he will make a statement on the matter. [5001/22]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
773. Deputy Colm Burke asked the Minister for Health the funding allocation for 2022 for the expansion and development of primary care infrastructure; and if he will make a statement on the matter. [5002/22]
View answerAs 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.
774. Deputy Colm Burke asked the Minister for Health the additional funding that has been provided for the recruitment of primary care team staff in 2022; and if he will make a statement on the matter. [5003/22]
View answerIn Budget 2022, the Minister secured annual investment of €195m to enable the continued delivery of the Enhanced Community Care Programme. This investment is supporting a programmatic and integrated approach to the development of the primary and community care sector that, among other initiatives, includes the development of primary care teams within 96 new Community Healthcare Networks (CHNs). These networks will be central to the development of improved primary care services, and each will consist of between 4-6 primary care teams serving a local population of around 50,000.
The expansion of primary care capacity is key to delivering the ECC programme, with approximately 3,500 additional staff to be recruited overall. Of these, it is expected that around 1,900 will be recruited to Primary Care Teams within the CHNs while the remainder will be employed in new Community Specialist Teams, Community Intervention Teams or other initiatives being advanced under the ECC programme.
There is flexibility within the overall ECC budget given the scale of the reform programme and associated recruitment, but it is estimated that €100-€110m of the ECC allocation in 2022 will support recruitment of primary care team staff.
775. Deputy Colm Burke asked the Minister for Health the number of healthcare professionals employed under community intervention teams in 2019, 2020 and to 31 December 2021; the number employed by county and region in tabular form; and if he will make a statement on the matter. [5004/22]
View answerAs this is a service matter, I have asked the Health Service Executive to respond directly to the Deputy, as soon as possible.
776. Deputy Colm Burke asked the Minister for Health the action his Department will take to increase the number of general practitioners by an additional 1,260 to 1,660 general practitioners by 2028 in order to meet the needs of population growth and the significant growth of those aged 65 and over 85 years of age who are naturally high users of the service [5005/22]
View answerThe Government is aware of the workforce issues currently facing general practice and is working to ensure patients across the country continue to have access to GP services and that general practice is sustainable in all areas into the future.
Several measures to increase the number of practicing GPs have been undertaken in recent years. Changes have been made to the entry provisions to the GMS scheme to facilitate more flexible/shared GMS contracts, and to the retirement provisions for GPs under the GMS scheme. An enhanced supports package for rural GP practices was also introduced.
Recent developments in relation to general practice, in particular the 2019 Agreement on Contractual Reform and Service Development, have helped to re-establish general practice in Ireland as an attractive career choice. The additional investment, which will amount to €210 million annually once the Agreement is fully implemented, provides for an increase in capitation fees, improved maternity and paternity arrangements as well as increased rural practice supports. In addition, targeted on-going funding of €2 million will also be set aside to provide additional support to practices in deprived urban areas.
The number of entrants to GP training has increased from 120 in 2009 to 233 in 2021, with large increases made in recent years. Further increases are expected as responsibility for training has transferred from the HSE to the Irish College of General Practitioners.
These measures will see an increase in the number of GPs working in the State, improving access to GP services for patients throughout the country.
777. Deputy Colm Burke asked the Minister for Health if consideration will be given to providing an enhanced range of supports including but not exclusively tax relief to assist in the funding of premises or critical equipment, infrastructural equipment including information technology systems and medical equipment to assist general practitioners establishing practices particularly those starting off in their career; and if he will make a statement on the matter. [5006/22]
View answerGPs are private contractors, most of whom hold contracts with the HSE for the provision of medical services such as contracts under the General Medical Services (GMS) Scheme for the provision of medical services without charge to patients who hold a medical card or GP visit card. In addition to direct remuneration for medical services provided under the GMS contract, the contract provides a range of GP practice supports including practice staff supports and supports for rural practices and for those working in disadvantaged urban areas.
As GPs are self-employed practitioners, they therefore may establish practices at a place of their own choosing.
The 2019 GP 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, including ensuring the sustainability of the business model for practices. The outcome of this review will inform future contractual changes.
778. Deputy Colm Burke asked the Minister for Health if consideration will be given to providing a partnership pathway support funding model to allow for existing general practitioners to take on assistants to enter into succession arrangements to take over the practice on a phased basis; and if he will make a statement on the matter. [5007/22]
View answerGPs are private contractors, most of whom hold contracts with the HSE for the provision of medical services such as contracts under the General Medical Services (GMS) Scheme for the provision of medical services without charge to patients who hold a medical card or GP visit card. In addition to direct remuneration for medical services provided under the GMS contract, the contract provides a range of GP practice supports including practice staff supports and supports for rural practices and for those working in disadvantaged urban areas.
Under the 2019 GP Agreement on Contractual Reform and Service Development, a working group consisting of members from the Department of Health, the HSE and the IMO, has been established to review current GMS succession arrangements in order to streamline succession arrangements and reduce the succession timeframe. The working group made significant progress prior to interruption by the Covid-19 pandemic, it is hoped that this work will be finalised in the near future. However, there are currently no plans to implement funding supports related to succession arrangements.
The 2019 GP 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.
779. Deputy Colm Burke asked the Minister for Health the action his Department will take to adjust and update the general practitioners practice team model to take account both of the broad range of skills required in practice to meet new models of care and to free up skilled personnel for more complex tasks; and if he will make a statement on the matter. [5008/22]
View answerThe Government is committed to developing primary and community services across the country. We also remain committed to the continued development of GP capacity to ensure that patients continue to have access to GP services.
GPs are self-employed practitioners and therefore may establish practices at a place of their own choosing and employ additional staff as they see fit. Under the GMS scheme, the HSE contracts GPs to provide medical services without charge to medical card and GP visit card holders. GPs are remunerated for these services primarily on a capitation basis, with a range of additional support payments and fees for specific items of service. Under the GMS scheme, GPs are paid a subsidy towards the cost of employing a practice nurse and/or a practice secretary. Group practices may also qualify for a subsidy to employ a practice manager.
Recent developments in relation to general practice, in particular the 2019 Agreement on Contractual Reform and Service Development, have helped to re-establish general practice in Ireland as an attractive career choice. The additional investment, which will amount to €210 million annually once the Agreement is fully implemented, provides for an increase in capitation fees, improved maternity and paternity arrangements as well as enhanced supports for rural practices. In addition, targeted funding of €2 million will also be set aside to provide additional support to practices in deprived urban areas.
The 2019 GP 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 Government is open to considering other options of support for general practice as part of the strategic review. The outcome of this review will inform future contractual changes, with preparatory work for the review having begun this year.
In Budget 2022, the Minister secured annual investment of €195m to enable the continued delivery of the Enhanced Community Care (ECC) Programme. Amongst other initiatives, the funding will allow for the rollout of 96 Community Healthcare Networks (CHNs) to be completed across the country by the end of 2022. These networks will be central to the development of improved primary and community services. They will involve new ways of working and are designed to empower local GPs, nurses, and other health professionals to lead at the local level, with key roles for GP Leads and Network Managers.
The ECC programme represents a significant expansion in primary care capacity, and will see some 3,500 additional staff recruited overall, with around 2,300 staff to be recruited in 2022, with a particular focus on nursing and health and social care professionals thereby delivering on the Sláintecare vision of enabling the provision of the right care, at right time, in the right place.
780. Deputy Colm Burke asked the Minister for Health if consideration will be given to adjusting the general practitioner practice team model in order to support broader general practitioner practice team members by expanding the grant aid available to take on additional nursing staff; and if he will make a statement on the matter. [5009/22]
View answerGPs are self-employed practitioners and therefore may establish practices at a place of their own choosing and employ additional staff as they see fit. Under the GMS scheme, the HSE contracts GPs to provide medical services without charge to medical card and GP visit card holders. GPs are remunerated for these services primarily on a capitation basis, with a range of additional support payments and fees for specific items of service.
Under the scheme, GPs can claim a subsidy towards the cost of employing a practice nurse and/or a practice secretary. Payment is made to participating doctors with a panel size of at least 100 patients and payment increases in bands of 100 with a maximum payment applicable at a panel size of 1,200. The subsidy rate applies to staff employed on a full-time basis. In relation to staff not employed on a full-time basis, payment is made on a pro rata basis.
Recent developments in relation to general practice, in particular the 2019 Agreement on Contractual Reform and Service Development, have helped to re-establish general practice in Ireland as an attractive career choice. The additional investment, which will amount to €210 million annually once the Agreement is fully implemented, provides for an increase in capitation fees, improved maternity and paternity arrangements as well as enhanced supports for rural practices. In addition, targeted funding of €2 million will also be set aside to provide additional support to practices in deprived urban areas.
The 2019 GP 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 Government is open to considering other options of support for general practice as part of the strategic review. The outcome of this review will inform future contractual changes, with preparatory work for the review having begun this year.
781. Deputy Colm Burke asked the Minister for Health if consideration will be given to adjusting the general practitioner practice team model to provide initiatives and support for the recruitment of particular allied health professional expertise on a full-time or sessional basis to benefit the broad needs of the patient population including physiotherapists, counselling and pharmacy support; and if he will make a statement on the matter. [5010/22]
View answerThe Government is committed to developing primary and community services across the country. We also remain committed to the continued development of GP capacity to ensure that patients continue to have access to GP services.
GPs are self-employed practitioners and therefore may establish practices at a place of their own choosing and employ additional staff as they see fit. Under the GMS scheme, the HSE contracts GPs to provide medical services without charge to medical card and GP visit card holders. GPs are remunerated for these services primarily on a capitation basis, with a range of additional support payments and fees for specific items of service. Under the GMS scheme, GPs are paid a subsidy towards the cost of employing a practice nurse and/or a practice secretary. Group practices may also qualify for a subsidy to employ a practice manager.
Recent developments in relation to general practice, in particular the 2019 Agreement on Contractual Reform and Service Development, have helped to re-establish general practice in Ireland as an attractive career choice. The additional investment, which will amount to €210 million annually once the Agreement is fully implemented, provides for an increase in capitation fees, improved maternity and paternity arrangements as well as enhanced supports for rural practices. In addition, targeted funding of €2 million will also be set aside to provide additional support to practices in deprived urban areas.
The 2019 GP 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 Government is open to considering other options of support for general practice as part of the strategic review. The outcome of this review will inform future contractual changes, with preparatory work for the review having begun this year.
In Budget 2022, the Minister secured annual investment of €195m to enable the continued delivery of the Enhanced Community Care (ECC) Programme. Amongst other initiatives, the funding will allow for the rollout of 96 Community Healthcare Networks (CHNs) to be completed across the country by the end of 2022. These networks will be central to the development of improved primary and community services. They will involve new ways of working and are designed to empower local GPs, nurses, and other health professionals to lead at the local level, with key roles for GP Leads and Network Managers.
The ECC programme represents a significant expansion in primary care capacity, and will see some 3,500 additional staff recruited overall, with around 2,300 staff to be recruited in 2022, with a particular focus on nursing and health and social care professionals.
782. Deputy Colm Burke asked the Minister for Health if consideration will be given for the development of a structured care programme in the area of women’s health within general practice which would deal exclusively with reproductive health, including contraception, maternity care and menopause; and if he will make a statement on the matter. [5011/22]
View answerImproving women’s health outcomes is a key priority for me and this Government. We made a strong commitment to Promoting Women’s Health in the Programme for Government and are fully committed to the development and improvement of Women’s Health services and to working with women and girls to improve their health across the whole life cycle.
This commitment has been reflected within Budget 2022, in the allocation of €31 million for new development funding to specifically support women’s health.
Underscoring the government’s commitment to Women’s Health has been the establishment of a Women’s Health Taskforce in September 2019 to improve both health outcomes and experiences of healthcare for women and girls. The Irish College of GPs (ICGP) are active members of the Women's Health Taskforce and continue to be engaged on how women's health can be better considered within the primary care setting.
Related activity includes a number of education and training courses run throughout the year, including the establishment in September 2021 of a GP Education Course in the area of Community Gynaecology which includes topics such as contraception, sexual health and fertility. In addition, funding has been provided through the Women's Health Fund to develop a 'quick reference guide' for GPs on the menopause, to support primary care provision in this area.
An ICGP post of Clinical Lead for Women’s Health in General Practice, the first such post in Ireland, is currently being progressed. Once in place, the Clinical Lead will provide the essential leadership to drive forward an ambitious agenda to enable a comprehensive life-course approach to women’s health in general practice.
783. Deputy Colm Burke asked the Minister for Health if a review will be carried out into the current package of supports for rural general practitioner practices, taking into account the fact that these supports would continue to be developed and enhanced to meet the very specific requirements of patients in these rural areas to ensure continuity of care for patients and that general practice is sustainable; and if he will make a statement on the matter. [5012/22]
View answerThe Government is aware of the workforce issues currently facing general practice, including the limited access to GP services in certain areas. The Government has committed to providing significant additional resources to general practice to help to meet those challenges. We are working to ensure patients across the country continue to have access to GP services and that general practice is sustainable in all areas into the future.
Several efforts to increase the number of practising GPs have been undertaken in recent years. The number of entrants to GP training has increased from 120 in 2009 to 233 in 2021, with large increases made in recent years. Further increases are expected as responsibility for training has transferred from the HSE to the Irish College of General Practitioners. Changes have been made to the entry provisions to the GMS scheme to facilitate more flexible/shared GMS contracts, and to the retirement provisions for GPs under the GMS scheme.
An enhanced supports package for rural GP practices was also introduced.
Recent developments in relation to general practice, in particular the 2019 Agreement on Contractual Reform and Service Development, have helped to re-establish general practice in Ireland as an attractive career choice. The additional investment, which will amount to €210 million annually once the Agreement is fully implemented, provides for an increase in capitation fees, improved maternity and paternity arrangements as well as enhanced supports for rural practices. In addition, targeted funding of €2 million will also be set aside to provide additional support to practices in deprived urban areas.
The 2019 GP 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 Government is open to considering other options of support as part of the strategic review. The outcome of this review will inform future contractual changes, with preparatory work for the review having begun this year.
784. Deputy Colm Burke asked the Minister for Health if consideration will be given to the implementation of the healthcare innovation Sligo cataract scheme nationally in which community optometrists co-work with hospital surgeons in order to improve public eye health and address the waiting list for public eye-care which remains high at 46,000; and if he will make a statement on the matter. [5017/22]
View answerAs this refers to an individual case, I have referred this matter to the HSE for their attention and direct reply to the Deputy.
785. Deputy Colm Burke asked the Minister for Health if consideration will be given to the implementation of a new eye-care programme for school-going children (details supplied); and if he will make a statement on the matter. [5018/22]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
786. Deputy Colm Burke asked the Minister for Health if consideration will be given to extending the role of optometrists in providing more services including the delivery of further treatments (details supplied); and if he will make a statement on the matter. [5019/22]
View answer787. Deputy Colm Burke asked the Minister for Health if a greater role for optometrists will be sanctioned by his Department in the interest of improving public eye health and eye-care services across the country and reducing the waiting list for public eye-care (details supplied); and if he will make a statement on the matter. [5020/22]
View answerI propose to take Questions Nos. 786 and 787 together.
I value the important role community optometrists play in our Health Service in the delivery of holistic patient care. In particular, I fully acknowledge that community optometrists have played a key role in responding to the health needs of the public during the COVID-19 pandemic.During COVID-19 optometrists have been responsive to the challenges presented and have developed guidelines and procedures to safely deliver patient care. I also recognise that optometrists have also played an important role in the delivery of the COVID-19 vaccination campaign. The current contract with Optometrists dates back to 1999 and it is accepted that it is has not kept pace with developments that have taken place over the course of recent years including the recommendations from the 2017 Primary Care Eye Services Review Group Report, interdisciplinary collaboration and the skillset that optometrists have by virtue of their education and training.I am fully committed to the development of community services which can facilitate expanded and more integrated provision of eye care in local communities. In this context, a contractual relationship between optometrists and the HSE which is modernised to emphasise a strengthened primary care system will be required.However, any publicly funded service expansion should address unmet public healthcare needs, improve access to existing public health services or provide better value for money or patient outcomes. Accordingly, any measures to be considered must be evidence-based.The HSE is continuing to prioritise the development of Primary Care Eye Teams in CHOs 6, 7 and 9 in 2022 with a view to extending these teams to other CHOs. A recent CHO9 initiative by the Community Paediatric Ophthalmology Service at the Grangegorman Primary Care Centre addressed waiting lists and enabled the training of the optometrist into expanded roles.In 2022, the HSE will also advance the transfer of care for children aged 8+ years to local optometrists, thereby reducing waiting lists and enhancing access to primary eye care services. It is anticipated that it will be possible to bring the project to conclusion over a 6-to-9-month time frame in 2022.
788. Deputy Michael Creed asked the Minister for Health if he will confirm receipt of correspondence from an organisation (details supplied) with regard to the 23% VAT rate being applied to payments from associates to principal dentists; if he has received an explanation regarding the rationale for introducing the charge at this point; the reason payments to date were exempt from such charges; and if he will make a statement on the matter. [5024/22]
View answerThe Department of Health received correspondence from the Irish Dental Association in December 2021 with regard to the 23% VAT rate applied to payments from associates to principal dentists. The Department of Finance was consulted and has advised that the supply of goods and services by a principal dentist to an associate dentist is subject to the requirements of the EU VAT Directive, with which Irish VAT law must comply.
The Minister understands that The Department of Finance has consistently outlined that position to the Irish Dental Association, and that there is no scope for any derogation in that regard.
The supply of dental services direct to patients is exempt from VAT under EU law.
790. Deputy David Cullinane asked the Minister for Health the number of persons waiting on diagnostics waiting lists; the number waiting more than three months; and if he will make a statement on the matter. [5030/22]
View answerThe HSE advises that a pilot project commenced in 2016 by the HSE Acute Hospitals Division to progress the collection of national radiology waiting list data. The project has been supported by the Radiology Clinical Care Programme and has involved key stakeholders across the system including the National Integrated Medical Imaging System (NIMIS) Team, Hospital Groups, and the support of the National Treatment Purchase Fund (NTPF) for data collection and data management expertise.
The latest available diagnostic waiting list data is outlined in the documents attached, which set out waiting list data for Quarter 4 2021 for CT, MRI and Ultrasound. The HSE advises that, at present, the further diagnostic scans requested by the Deputy (including cholangiopancreatography, electroencephalogram, angiogram, and bone scan), are not yet captured as part of this project.
The information that is currently being collected is presently being tested and validated at hospital, hospital group and national level and as such should not be used/reported without the context of the caveats set out below:
- Data is subject to inclusions and exclusions which are documented in the Data Profile Document. This document is available from Acute Operations and has been circulatedto all Hospital Groups.
- Data contains urgent, routine and surveillance/planned activity which is currently not broken down in detail, as such this includes surveillance/planned activity which may not be exceeding planned date.
- Data is still undergoing validation at Hospital and Hospital Group level.
- Data does not take into account local nuances at site level (Site profile developed to support understanding of same).
- The purpose of this aggregate data is to provide a National Level overview of the number of patients waiting for modalities of CT, MRI and Ultrasound.
- This report is not intended to be used for the active management of hospital diagnostics waiting list, local reports and mechanisms should continue to be used for the management of diagnostics waiting lists at hospital level.
In Q4 2021, there were a total of 226,966 patients reported on the waiting list from all sites, this represents all outpatients waiting, urgent, semi urgent, routine and planned/surveillance (where diagnostic access is planned at particular time intervals).
