Written Answers Nos. 165-186
165. Deputy Brendan Griffin asked the Minister for Health the progress of plans to address the recruitment challenge in the health service which has left a significant number of consultant and hospital posts vacant leading to poorer outcomes for patients, including in mental healthcare. [7833/22]
View answerAs a result of the commitment to sufficiently staff the health service into the long-term, 2020 and 2021 have seen record numbers recruited into the workforce. 2020 saw the largest increase in the health sector workforce since the foundation of the HSE, with 2021 having the second largest. Since the beginning of January 2020, an additional 12,506 WTE have been added to the workforce, which is an increase of 10% above 2019 levels. 7,592 of these WTE have been additional to the Acute sector.
Budget 2022 has provided funding for a further large-scale expansion of the health service workforce. A risk has been identified of a reduction of labour supply, given the large amount of recruitment that has already been achieved. To mitigate the risks associated with recruitment in 2022 and to achieve recruitment targets to the fullest extent possible, a number of steps are being taken by the HSE including expanding recruitment capacity, engaging third party agencies to carry out recruitment and expansion of international recruitment frameworks.
With regard to consultant recruitment specifically, in 2021 the Health Service Executive undertook a full review of their processes for the recruitment of consultants to the health service. A Recruitment & Resourcing Governance Steering Group was established and in line with the work of this group, a small Working Group formed to specifically examine processes around the recruitment of Medical Consultants.
An ‘end to end’ process mapping of the approval and recruitment process was completed by the Working Group which highlighted several areas for improvement and work is ongoing in this regard, however several measures have already been taken to improve this recruitment process.
These include revising the process for the Consultant Applications Advisory Committee (CAAC) and National Recruitment Service (NRS) application form and Job Specification, reviewing consultant competencies and implementing revised and safe screening processes to reduce duplication and times to hire.
The benefits of the targeted approaches taken to consultant recruitment are emerging in our performance since the onset of the pandemic with an excess of +300 WTE consultants in post above December 2019 levels. The HSE are working with the PAS to ensure that the appropriate infrastructure and resources are in place within the PAS to process the continued increase in 2022.
Looking forward, there are several initiatives planned for 2022 to build on the progress made and improve further on the recruitment and retention of consultants to the health workforce in Ireland.
These will include reducing the time costs associated with the application process and onboarding of consultants. Ensuring there is greater transparency and access to concurrent data on consultant recruitment status activity and the development of comprehensive marketing including a Medical Consultant microsite Increased access to supports when engaging in the application process. The centralisation of administration requirements which will deliver a reduction in the duplication of processes across multiple sites.
The deputy may wish to note that there has been a 17% increase of Higher Specialist Trainees since 2017 which, going forward, will translate into more qualified candidates for consultant roles as they complete training.
166. Deputy Pearse Doherty asked the Minister for Health the progress that has been made in relation to the full publication of a report (details supplied) into abuse at a facility in County Donegal; and when the full report will be published. [7719/22]
View answerThe HSE commissioned the National Independent Review Panel to carry out a review of a residential service for adults with a disability at Ard Greine Court, Stranorlar, Co Donegal. The review report, the Brandon Report, focuses on matters of a sensitive nature, and how they were managed.
It is imperative that this report leads to learning, with ensuing meaningful and tangible change. We must ensure there cannot be such serious safeguarding failures in other settings. I have on a number of occasions asked the HSE to publish the report in full.
Having sought the Attorney General’s advice on the matter, it’s clear that neither I nor the Minister for Health may direct the HSE to publish the Report. No legal basis has been identified that would permit me to publish the report.
The Attorney is of the view that it would not be permissible for the Minister for Health to publish the report where the HSE, as the body responsible for publication under the NIRP guidelines, has determined the Report should not be published in full. On the 16th December 2021 the HSE published an executive summary.
167. Deputy Seán Haughey asked the Minister for Health if section 39 workers will receive the pandemic bonus payment. [7904/22]
View answerThe Deputy raises an important question about workers who supported the national effort over the past two years to meet the challenges of COVID-19.
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.
Also, noting the unique additional challenges and risks in the health sector during this period, the Government announced COVID-19 recognition payment for frontline public sector healthcare workers. Importantly and distinctly from other workers, those eligible are, in general, frontline public sector healthcare workers who are directly employed and worked or trained in COVID-19 exposed environments / clinical settings.
The Department of Health will also introduce a similar measure for frontline staff in all nursing homes and hospices (whether public, private, voluntary, Section 39 etc.). This measure will address the specific challenges associated with making payment to these organisations including governance and scope.
I am also mindful of other healthcare workers who played their own part during this difficult period in sustaining our health service but did not work in such exposed areas. It is tough to draw a line on this matter, but the Government based its decision on the risks which frontline healthcare workers faced.
We are working together with the HSE to provide additional details on this measure including full eligibility criteria, particulars and terms and conditions that apply. This will be published as soon as possible.
168. Deputy Pauline Tully asked the Minister for Health his plans to review the Northern Ireland planned healthcare scheme in order to align the rate being charged for procedures undertaken by hospitals in Northern Ireland with the rate paid by the HSE given that this can often be seriously misaligned and can burden patients with large additional costs and act as a disincentive to persons from undergoing necessary procedures; the timeframe for a permanent statutory scheme to be put in place to replace the temporary Northern Ireland planned healthcare scheme; and if he will make a statement on the matter. [7896/22]
View answerThe Northern Ireland Planned Healthcare Scheme 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 Government intends to place the administrative Northern Ireland Planned Healthcare Scheme on a statutory basis and an extensive examination of options to inform the drafting of a General Scheme is currently underway. It is also important to note that the administrative scheme will remain until such time that a statutory scheme is in place.
The Northern Ireland Planned Healthcare 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. 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. Rates of reimbursement are set by the HSE and are those applicable to the cost of treatment in the public health service in Ireland. Furthermore, reimbursement is confined to the costs of the care itself and does not include any additional costs incurred by the patient such as travel or accommodation costs.
Patients are advised to contact the HSE NI Planned Healthcare office directly for further information on individual applications for reimbursement under the NI Planned Healthcare Scheme. Contact details are available on the HSE NI Planned Healthcare website.
169. Deputy Peadar Tóibín asked the Minister for Health if his Department has undertaken an assessment of the impact of Covid-19 restrictions or lockdowns on cancer services; if his attention has been drawn to an increase or perceived increase in cancer diagnosis during the pandemic; if so, the names of the persons or bodies that alerted him to such an increase; and the dates upon which his attention was drawn to the matter. [7775/22]
View answerMy Department and the National Cancer Control Programme (NCCP) systematically study the impact of Covid-19 on cancer services through data monitoring and monthly review meetings.
During Wave 1 of Covid in March-May 2020, in line with experiences internationally, there was a significant drop in the numbers of people presenting with cancer concerns. From the outset of the pandemic, great focus has been placed by the cancer services on providing safe patient pathways and encouraging people to come forward. Urgent cancer services were maintained throughout the pandemic.
By the time Wave 2, and subsequent Covid Waves, occurred, the degree of resilience built up in cancer services, through staff commitment, revised treatment guidelines, social distancing and infection prevention and control measures, instilled confidence in people that they could access cancer diagnostics and treatment. Accordingly, services were much less impacted.
As indicated, we are continuing to closely monitor trends in numbers coming forward to diagnostic services, and the level of attendances for appointments for treatment. Based on the most recent figures available:
- the total number of GP e-referrals to cancer Rapid Access Clinics for 2021 stands at 130% of the activity in 2019;
- the total number of patients seen across all Rapid Access Clinics for 2021 stands at 102% of the activity in 2019;
- the number of patients receiving chemotherapy for January-November 2021 is at approximately 95% of 2019 activity;
- the number of patients receiving radiation oncology for January-November 2021 is at 85% of 2019 activity; and
- the number undergoing surgical oncology for January-November 2021 is at 80%.
In December 2021, the Royal College of Physicians Ireland (RCPI), in conjunction with organisations such as the National Cancer Registry Ireland (NCRI) and NCCP, published a report titled 'Cancer care in Ireland in 2020 – The impact of the COVID-19 pandemic'. NCRI data included in the report indicates that, as expected, the number of cancer diagnoses in 2020 was lower than in 2019 due to Covid-19. While the full extent of the impact of Covid-19 on cancer patients will not be known until the NCRI 2020 data reaches maturity, the NCRI suggests that the reduction may be between 10% and 14% of the expected figure (which allows for increasing trends due to our increasing and ageing population).
The Government has provided significant extra funding for cancer services in Ireland. Funding of €5m has been provided in 2022 to continue the work of supporting cancer services and increasing capacity in the context of Covid-19. This is in addition to the €12m allocated in 2021. This funding is facilitating additional clinics and the extension of clinic times, as well as allowing for minor infrastructural works to be carried out and for locum and temporary staff to be recruited to support the delivery of services. In addition, there has been significant investment over the last two years for implementation of the National Cancer Strategy, with €20m provided in 2021 and a further €20m in 2022. This funding is being utilised to advance the prevention, diagnosis and treatment of cancer and to provide continued support for patients living with and beyond cancer.
In conclusion, I would emphasise that it remains important to stress that anyone with concerns about cancer should visit their GP, who will arrange appropriate follow-up care. Our cancer diagnostic and treatment services are open, and our healthcare staff will provide any necessary care.
170. Deputy Richard Boyd Barrett asked the Minister for Health his plans to fill the vacant posts in CAMHS across the country as one of the measures to ensure that children are not being overmedicated; and if he will make a statement on the matter. [7971/22]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
171. Deputy Pádraig O'Sullivan asked the Minister for Health if secondary school students that could not avail of the HPV vaccine due to the fact that they started the school year in 2018-2019 will be able to avail of the vaccine at a later date; and if he will make a statement on the matter. [7766/22]
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, 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.
I have asked my officials to request the National Immunisation Advisory Committee 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.
172. Deputy Alan Farrell asked the Minister for Health the status of the work of the Food Reformulation Task Force and the efforts to implement the Roadmap for Food Product Reformulation in Ireland; and if he will make a statement on the matter. [7909/22]
View answer“A Roadmap for Food Product Reformulation in Ireland” was launched on 3rd December 2021 by Minister Donnelly and myself. The establishment of a Food Reformulation Task Force to implement the Roadmap was also announced. The publication of the Reformulation Roadmap fulfils a key element of the Obesity Policy and Action Plan 2016-2025 and of the Healthy Ireland Strategic Action Plan 2021-2025. It was prepared by the Reformulation Sub-Group of the Obesity Policy Implementation Oversight Group (OPIOG).
As stated in the Roadmap, the Food Reformulation Task Force has been established and is situated within the Food Safety Authority of Ireland (FSAI). The Task Force is being funded by the Department of Health and the position of the Task Force Lead has been filled, with further recruitment underway. A detailed workplan for the Task Force is in development. As also stated in the Roadmap, the Task Force will be overseen by an Oversight and Monitoring Group chaired by the Principal Officer of the Health and Wellbeing Programme, Department of Health, and will include representatives of the Department, FSAI and OPIOG.
173. Deputy Jim O'Callaghan asked the Minister for Health if homecare workers will receive the pandemic bonus payment. [7906/22]
View answerI would like to thank the Deputy for raising this important topic.
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.
Also, noting the unique additional challenges and risks in the health sector during this period, the Government announced COVID-19 recognition payment for frontline public sector healthcare workers. Importantly and distinctly from other workers, those eligible are, in general, frontline public sector healthcare workers who are directly employed and worked or trained in COVID-19 exposed environments / clinical settings.
The Department of Health will also introduce a similar measure for frontline staff in all nursing homes and hospices (whether public, private, voluntary, Section 39 etc.). This measure will address the specific challenges associated with making payment to these organisations including governance and scope.
I am also mindful of other healthcare workers who played their own part during this difficult period in sustaining our health service but did not work in such exposed areas. It is tough to draw a line on this matter, but the Government based its decision on the risks which frontline healthcare workers faced.
We are working together with the HSE to provide additional details on this measure including full eligibility criteria, particulars and terms and conditions that apply. This will be published as soon as possible.
174. Deputy Richard Bruton asked the Minister for Health the size of the budget for medicines; and the plans to manage it more effectively. [6836/22]
View answerBudget 2022 allocated €30m for new medicines which will ensure access to new innovative medicines, including those for rare diseases.
Under the Health (Pricing and Supply of Medical Goods) Act 2013, the HSE has statutory responsibility for the administration of the community drug schemes; therefore, the matter has been referred to the HSE for attention and direct reply to the Deputy.
175. Deputy Holly Cairns asked the Minister for Health the steps he is taking to address waiting lists for assessments and therapies for the children’s disability network teams in south-west areas of County Cork. [7899/22]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
176. Deputy Duncan Smith asked the Minister for Health his plans to tackle the ongoing trolley crisis; and if he will make a statement on the matter. [7725/22]
View answerI wish to acknowledge the distress overcrowded Emergency Departments cause to patients, their families, and frontline staff working in very challenging conditions in hospitals throughout the country. The health sector is expecting to face significant challenges this winter in providing emergency care while also dealing with Covid-19. Emergency department attendances are close to 2019 levels, exceeding them at some sites, while the numbers of patients waiting on trolleys have been increasing steadily since June 2021.
I met with senior HSE management on the 9th February to discuss the current challenges facing emergency departments. They outlined some very specific challenges in the system at the moment. Higher than normal levels of attendance in recent weeks, combined with around 600 Covid-19 inpatients and 600 delayed transfers of care, is putting intense pressure on hospital capacity. It is increasingly difficult to discharge some patients who need nursing home or stepdown care due to the number of Covid-19 outbreaks in nursing homes. There are also difficulties in discharging some patients home due to issues with providing home care. These issues are compounded by the level of staff absenteeism related to Covid-19. I have requested the HSE to take all appropriate action to mitigate these challenges, as far as possible.
We have put significant resources into preparing the system for winter. 1,146 acute hospital beds were funded under last year’s Winter Plan and Budget 2021. To date, over 800 acute beds have opened since the 1st January 2020 across the hospital system, excluding critical care beds.
The HSE Winter Preparedness Plan for Winter 21/22 builds on the significant investment in last year’s Winter Plan and the additional capacity delivered in health services in 2021, and centres on three core objectives: ED avoidance, patient flow and hospital egress to mitigate the expected challenges in providing emergency care during winter while also continuing to respond to Covid-19.
The Plan recognizes that a whole system response is required and outlines how the HSE proposes to manage these challenges across primary, community and acute care including measures to allow the public system to access private healthcare capacity.
This plan endorses a home first approach, enabling and facilitating patients to receive the most appropriate care in their own homes and communities.
The Plan contains a number of initiatives to deliver its core objectives of ED avoidance by treating people at home or in the community and by allowing them to return home following hospitalisation quickly. These initiatives include:
- GP Liaison Nurses to manage direct referrals from GPs to ED;
- Geriatric Community Support;
- Enhancement and expansion of Frailty Intervention Therapy Team models;
- Community Response Teams (nursing and therapies);
- Community respiratory admission avoidance teams;
- Expansion of the National Ambulance Service Pathfinder initiative
- Additional home support hours and
- COPD outreach teams.
177. Deputy Jennifer Carroll MacNeill asked the Minister for Health if there are plans to increase the number of sexual assault treatment units nationally; the level of current delays in the processing of forensic evidence at SATU; and if he will make a statement on the matter. [7760/22]
View answerAs the Deputy may be aware there are currently 6 Sexual Assault Treatment Units (SATUs) in Ireland. These are:
- Cork SATU located in South Infirmary Victoria University Hospital,
- Donegal SATU located at Justice Walsh Road in Letterkenny,
- Dublin SATU located in Rotunda Hospital Campus,
- Galway SATU located in Brockagh, Co. Galway,
- Mullingar SATU located in Midland Regional Hospital and
- Waterford SATU located in University Hospital Waterford.
There are currently no plans to increase the number of SATUs.
One of the functions of SATUs is the collection of forensic evidence, which is then provided to the Gardaí for processing by Forensic Science Ireland at Garda Headquarters. My colleague, the Minister for Justice. is responsible for this area.
178. Deputy Barry Cowen asked the Minister for Health the number of children waiting for a CAMHS appointment in the Laois-Offaly local health office area; the number of these children who are also on a waiting list for a primary care psychology appointment; if he plans to audit, review or reform the CAMHS service in the area in the wake of recent issues; and if he will make a statement on the matter. [7946/22]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
180. Deputy Niamh Smyth asked the Minister for Health the status of the Mental Health Strategy (details supplied); and if he will make a statement on the matter. [7795/22]
View answerAs this is a service matter I have asked the Health Service Executive to respond directly to the Deputy as soon as possible.
181. Deputy Duncan Smith asked the Minister for Health the status of the provision of a primary care centre in Swords, County Dublin; and if he will make a statement on the matter. [7724/22]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
182. Deputy Joan Collins asked the Minister for Health the cause of the delay in issuing updated EU Digital COVID Certificates (details supplied). [7677/22]
View answerDigital COVID Certificates for booster doses of COVID-19 vaccines are now being issued in Ireland. The certificates are being issued via email or print (upon request) to individuals who have already received their booster vaccination.
The DCC helpline has recently received a significant volume of calls following the release of the booster certificates and wait times may currently vary. A dedicated team is manually processing all outstanding DCC cases with urgency to ensure the remaining DCCs are issued in a timely manner.
183. Deputy Pauline Tully asked the Minister for Health the reason that patients presenting to Cavan General Hospital accident and emergency department requesting treatment for mental health issues are being turned away without intervention; and if he will make a statement on the matter. [7897/22]
View answerTo ask the Minister for Health if he will provide details on the pathways of mental health care for children and adolescents in Ireland; and if he will make a statement on the matter.
184. Deputy Mick Barry asked the Minister for Health if he will ensure that student nurses due to receive payments for working during the Covid-19 pandemic will be paid immediately; and if he will make a statement on the matter. [7960/22]
View answerIn 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.
Also, noting the unique additional challenges and risks in the health sector during this period, the Government announced COVID-19 recognition payment for frontline public sector healthcare workers. Importantly and distinctly from other workers, those eligible are, in general, frontline public sector healthcare workers who are directly employed and worked or trained in COVID-19 exposed environments / clinical settings. This measure includes supernumerary students (including supernumerary student nurses and internship student nurses) who were required to perform training in clinical sites
The Department of Health will also introduce a similar measure for frontline staff in all nursing homes and hospices (whether public, private, voluntary, Section 39 etc.). This measure will address the specific challenges associated with making payment to these organisations including governance and scope.
We are working together with the HSE to provide additional details on this measure including full eligibility criteria, particulars and terms and conditions that apply. This will be published as soon as possible.
185. Deputy David Stanton asked the Minister for Health the measures being taken by his Department to support the increased numbers of general practitioners for training and setting up practices; and if he will make a statement on the matter. [7721/22]
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.
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.
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.
186. Deputy Joe Flaherty asked the Minister for Health the number of home support hours that will be provided to older persons in counties Longford and Westmeath during 2022. [7876/22]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.
