Thursday, 17 Feb 2022

Health Service Executive

Questions (285)

Michael Ring

Question:

285. Deputy Michael Ring asked the Minister for Health the reason that a response has not been forthcoming from the HSE on a query (details supplied); and if he will make a statement on the matter. [8835/22]

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Written answers

Minister of State at the Department of Health

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, in the earliest possible timeframe.

Primary Medical Certificates

Questions (286)

Michael Healy-Rae

Question:

286. Deputy Michael Healy-Rae asked the Minister for Health if a primary medical certificate application will be expedited in the case of a person (details supplied); and if he will make a statement on the matter. [8838/22]

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Written answers

Minister of State at the Department of Health

As the question raised by the Deputy relates to a service matter, I have arranged for the question to be referred to the HSE for investigation and direct reply to the Deputy.

Nursing Homes

Questions (287)

Gerald Nash

Question:

287. Deputy Ged Nash asked the Minister for Health his views on a policy issue raised by a person (details supplied) relating to nursing home charges; and if he will make a statement on the matter. [8840/22]

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Written answers

Minister of State at the Department of Health

The Nursing Homes Support Scheme (NHSS), commonly referred to as Fair Deal, is a system of financial support for people who require long-term residential care. Participants contribute to the cost of their care according to their means while the State pays the balance of the cost. The NHSS covers the cost of the standard components of long-term residential care which are:

- Nursing and personal care appropriate to the level of care needs of the person

- Bed and board

- Basic aids and appliances necessary to assist a person with the activities of daily living

- Laundry service

A person's eligibility for other schemes, such as the medical card scheme or the drugs payment scheme, is unaffected by participation in the NHSS or residence in a nursing home. In determining the services covered by the NHSS it was considered very important that the care recipient and the taxpayer would be protected and would not end up paying for the same services twice. For this reason, medications and aids that are already prescribed for individuals under an existing scheme are not included in the services covered by the NHSS, as this would involve effectively paying twice for the same service.

Although the NHSS covers core living expenses, residents can still incur some costs in a nursing home, such as social programmes, newspapers or hairdressing. In recognition of this, anyone in receipt of financial support under the NHSS retains at least 20% of their income. The minimum amount that is retained is the equivalent of 20% of the State Pension (Non-Contributory). An operator should not seek payment from residents for items which are covered by the NHSS, the medical card or any other existing scheme.

Part 7 of the Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2013 stipulates that the registered provider of the nursing home must agree a contract in writing with each resident on their admission to the nursing home. This contract must include details of the services to be provided to that resident and the fees to be charged. Residents should never be charged fees which are not set out in the contract. The Department of Health and the HSE are not a party to such contracts which are concluded between each resident and their nursing home.

Registered providers of nursing home care are obliged to provide an accessible and effective complaints procedure. Concerns about additional charges should in the first instance be taken up with the nursing home provider. The Office of the Ombudsman can examine complaints about the actions of a range of public bodies and, from 24 August 2015, complaints relating to the administrative actions of private nursing homes. The Office of the Ombudsman normally only deals with a complaint once the individual has already gone through the complaints procedure of the private nursing home concerned.

The Competition and Consumer Protection Commission (CCPC) is an independent statutory body with a dual mandate to enforce competition and consumer protection law in Ireland. CCPC’s mission is to promote competition and enhance consumer welfare. The CCPC has published consumer protection guidelines for contracts of care in long-term residential care services for older people. The guidelines set out the obligations and responsibilities that providers must adhere to under consumer protection law and are aimed at providing greater transparency, clarity and certainty for consumers.

General Practitioner Services

Questions (288)

Neale Richmond

Question:

288. Deputy Neale Richmond asked the Minister for Health when the free general practitioner care scheme will be extended to six- and seven-year-olds as per budget 2022; and if he will make a statement on the matter. [8847/22]

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Written answers

Minister for Health

The Government is committed to increasing access to GP care without charges for children, an important healthcare measure that will remove a potentially prohibitive cost barrier to accessing GP care and will help to improve children’s health as they develop. At present all children up to and including the age of 5 are eligible for a GP visit card and therefore GP care without charges.

The Health (General Practitioner Service and Alteration of Criteria for Eligibility) Act 2020 provides, amongst other things, for the phased expansion of GP care without fees to all children aged 12 years and under in three phases: to children aged 6 and 7; to children aged 8 and 9; and to children aged 10,11 and 12. Budget 2022 provides for the initial stage of this phased expansion, the provision of GP care without fees to all children aged 6 and 7. My officials and the HSE are already engaged in preparatory work, and I expect to be in a position to bring forward proposals to the IMO, representing GPs, later this quarter. It is important to ensure that any additional pressures placed on general practice will not limit its capacity to meet the needs of all patients in the community.

Medical Inquiries

Questions (289)

Pauline Tully

Question:

289. Deputy Pauline Tully asked the Minister for Health the position regarding the inquiry into the historical licensing and use of the anti-epileptic drug sodium valproate that his Department committed to in November 2020; the timeframe for this inquiry to take place; the position regarding the disability package for persons affected by valproate; and if he will make a statement on the matter. [8853/22]

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Written answers

Minister for Health

Officials in my Department are currently engaging with the relevant patient representative groups regarding the terms of reference for a potential inquiry into sodium valproate; no timeframe has been established for the inquiry.

Since 2018, the HSE has worked to improve the structures in place to support families affected by foetal valproate syndrome (FVS). A dedicated genetics clinic has been established in Our Lady’s Hospital, Crumlin. and the HSE has appointed several dedicated resources to carry out assessments; there is currently no waiting list for assessment in the FVS clinic.

In general, access to disability services is provided based on individual need, rather than a specific diagnosis, in keeping with the principles of the UN Convention on the Rights of Persons with Disabilities. However, patients who receive a diagnosis of FVS following assessment in the genetics clinic in Our Lady’s Hospital, Crumlin, are eligible for a care pathway specific to FVS.

Dental Services

Questions (290)

Paul Murphy

Question:

290. Deputy Paul Murphy asked the Minister for Health if his attention has been drawn to the difficulty experienced by those who hold a medical card and are seeking root canal treatment; and the way a family can proceed in order to receive this urgently needed treatment for a 17-year-old medical card holder from a low-income family who cannot afford the treatment given that the dentists they contacted have quoted up to €850. [8862/22]

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Written answers

Minister for Health

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Health Services

Questions (291)

Sorca Clarke

Question:

291. Deputy Sorca Clarke asked the Minister for Health if he will urgently intervene in the case of a person (details supplied); and if he will make a statement on the matter. [8865/22]

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Written answers

Minister of State at the Department of Health

I wish to advise the Deputy that given this is a service matter, it would be inappropriate for me to intervene, however, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.

Covid-19 Tests

Questions (292, 319)

Paul Murphy

Question:

292. Deputy Paul Murphy asked the Minister for Health further to Parliamentary Question No. 132 of 9 February 2022, if he will address the issue that this lack of access to recovery certificates is due to a failure of the HSE to provide PCR tests to potentially many thousands of persons therefore they are unable to obtain recovery certificates in lieu of a booster dose; and the way that his Department plans to resolve this issue for these persons. [8871/22]

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Denis Naughten

Question:

319. Deputy Denis Naughten asked the Minister for Health the process for a person who is under 40 years of age but over 16 years of age who has had their first and second vaccines and cannot receive their booster vaccine for three months given that they recently contracted Covid-19 and cannot apply for a Covid recovery certificate due to the fact they tested positive via a reported antigen test; and if he will make a statement on the matter. [8939/22]

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Written answers

Minister for Health

I propose to take Questions Nos. 292 and 319 together.

The EU Digital COVID Certificate Regulation (EU) 2021/953 creates a framework for the issuing, authentication, and validity of certificates. Under the scope and parameters laid out in the EU DCC Regulation, DCCs for recovery are not currently issued on the basis of antigen tests.

The EU Digital COVID Certificate is not a travel document or a requirement for travel, but a record of a medical event to help ease freedom of movement with the European Union. Any persons who wishes to travel to another EU country or access services aboard should familiarise themselves with the travel requirements of that country. Details are available at the Re-Open EU webpage: reopen.europa.eu/en

The immunisation programme in Ireland is based on the advice of the National Immunisation Advisory Committee (NIAC). The NIAC makes recommendations on vaccination policy to my Department based on the prevalence of the relevant disease in Ireland and international best practices in relation to immunisation.

There was very significant demand for PCR testing during December and into January due to unprecedented levels of infection in the community, largely driven by the Omicron variant and reflecting both the high prevalence of the disease and also other respiratory illnesses at the time. The HSE made every effort necessary to address this very significant demand arising for PCR testing. This included making arrangements with private providers to add new capacity, extending the opening hours of swabbing centres and ongoing recruitment and redeployment to swabbing teams, and increasing the number of National Ambulance Service mobile teams. Due to demands on PCR capacity reaching the levels they did, changes were necessary to public health guidance, making antigen tests more widely available and allowing the HSE to prioritise access to PCR testing for those most vulnerable to the disease.

Health Strategies

Questions (293)

Róisín Shortall

Question:

293. Deputy Róisín Shortall asked the Minister for Health the status of the women's health task force; the steps being taken to improve the diagnosis, management and treatment of endometriosis; and if he will make a statement on the matter. [8873/22]

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Written answers

Minister for Health

Improving 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.

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 members of the Taskforce meet regularly, with its fifteenth meeting held in November 2021.

An important part of the Taskforce’s work is to listen to the voices of women and engage with stakeholders both at an individual and organisation level at home and abroad who can share evidence expertise and experiences and ideas to help us achieve this goal. The Taskforce has listened to, engaged, and worked with more than 2,000 women and hundreds of stakeholders and organisations representing women and girls across the country.

We have made a specific commitment to supporting the work of the Women’s Health Taskforce, including the development of a Women’s Health Action Plan, to tackle a wide range of issues impacting women’s health outcomes in Ireland.

This Women’s Health Action Plan for 2022-2023 is currently being finalised and is expected to be brought before Government in the coming weeks. This plan has been informed by the available evidence and engagement with women across the country, key stakeholders, clinicians, and advocates for women’s health through the Women’s Health Taskforce.

The Action Plan sets forward a wide range of positive initiatives to support women’s health and provides a framework for further prioritisation as issues and needs arise.

The commitment to Women’s Health has been reflected within Budget 2022, in the allocation of €31 million for new development funding to specifically support women’s health.

The Women’s Health Fund was established in 2020 with a €5 million allocation in Budget 2021. The additional €5 million funding allocated to this Fund in Budget 2022 will allow us to continue to provide specific targeted funding on improving women’s health outcomes and experiences in Ireland.

In relation to endometriosis, a number of initial priority areas for action were determined by the Taskforce in 2020, with the issue of endometriosis recognised and included as part of a priority workstream on improving gynaecological health for women and girls.

The endometriosis workstream identified a number of potential actions in this area, including enhanced services and supports and increased information and awareness. There has been significant work underway to reflect these actions in implementation, including direct investment in services which I will mention in further detail shortly, and a public webinar on endometriosis which was held on November 24th 2021.

Information provided by the HSE indicates that endometriosis is a difficult condition to diagnose and treat because of the variation of presentations, impacting the physical and mental wellbeing of patients at varying levels. Treatment may include pain medications, hormone treatment and surgical interventions. The time to diagnose endometriosis varies by patient due to its varying and ambiguous symptom presentation. The HSE's National Women & Infants Health Programme has advised that the best way to help the majority of patients with endometriosis is to improve access to gynaecology services.

In relation to the treatment of endometriosis, I am advised that a GP referral to a gynaecologist is the standard pathway of care for the management of endometriosis in Ireland. This is similar to the pathway in place for the management of other gynaecological conditions.

The HSE’s National Women & Infants Health Programme has developed a plan to increase capacity and reduce waiting times for women awaiting general gynaecology, which includes patients with endometriosis. The plan aims to re-orient general gynaecology services to an ambulatory, or see and treat, model, rather than the traditional outpatient referral model. An ambulatory care model is a more efficient and effective use of resources. It is also better for the patient as it reduces the requirement for multiple outpatient appointments.

As such, the Programme has developed an Ambulatory Gynaecology Model of Care which centres on the establishment of one-stop “see and treat” ambulatory gynaecology clinics. An ambulatory care model is a more efficient and effective use of resources than the traditional outpatient model and it is also better for the patient as it reduces the requirement for multiple outpatient appointments.

Building on progress made in rolling out these ambulatory gynaecology clinics in 2020 and 2021, funding has been provided under Budget 2022 which will facilitate the establishment of additional ambulatory gynaecology clinics, thereby completing the implementation of the Ambulatory Gynaecology Model of Care. This will bring the total number of these clinics to 20 nationally.

As part of the work of the Women’s Health Taskforce, in April 2021, I announced the expansion of the endometriosis service at Tallaght University Hospital (TUH) to deliver a specialist endometriosis centre for the management and treatment of all forms of endometriosis, with particular focus on advanced and complex cases for which there had previously been no ready access in Ireland.

Further to the above, funding provided under Budget 2022 will enable the expansion of the endometriosis service at TUH as well as the establishment of a new service for more complex endometriosis cases at Cork University Maternity Hospital

The issue of endometriosis has also been highlighted through the nationwide “Radical Listening” exercise carried out by the Women’s Health Taskforce. This exercise enabled women across the country to share their views and experiences of the health sector and health services. This was a large-scale consultation process intended to maximise the participation of women across all life stages from 18 years upwards, including minority and disadvantaged women. 278 women participated in open interviews and workshops. A report on the findings of the ‘Radical listening’ exercise on September 14th can be found here:

www.gov.ie/en/publication/ebe3e-significant-milestone-as-minister-donnelly-publishes-a-report-of-womens-voices-on-womens-health-following-a-radical-listening-exercise-this-year/

Nursing Homes

Questions (294)

Paul Murphy

Question:

294. Deputy Paul Murphy asked the Minister for Health further to Parliamentary Question No. 709 of 8 February 2022, if this combined briefing report on the three nursing homes by HIQA to the Minister for Mental Health and Older People contains information that is not in the published inspection reports; and if he will consider publishing the report without redactions. [8876/22]

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Written answers

Minister of State at the Department of Health

As I have stated previously, I requested a briefing report, which was prepared by HIQA and submitted to me in July 2021, on the then position regarding the nursing homes referenced by the Deputy. The report was based on the findings of HIQA’s inspection reports on the three centres.

The Chief Inspector, HIQA, reports on their inspection findings and judgments in an inspection report. In the context of the three nursing homes in question, HIQA has confirmed that the inspection reports on which the briefing note was based have all been published on HIQA’s website in line with the normal regulatory process.

It should be noted that the publication of the briefing report is a matter for HIQA. I do note, however, that HIQA has provided the report under the FOI Act, with redactions in accordance with that Act.

Medical Cards

Questions (295)

Róisín Shortall

Question:

295. Deputy Róisín Shortall asked the Minister for Health if he plans to increase the income threshold for qualifying for a medical card in line with increases in the State pension to take account of the fact that those with private pensions move closer to the threshold when State pension payments increase; and if he will make a statement on the matter. [8878/22]

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Written answers

Minister for Health

Eligibility for a Medical Card is primarily based on a financial assessment which is conducted by the HSE in accordance with the Health Act 1970 (as amended). The HSE assesses each medical card application on a qualifying financial threshold. This is the amount of money that an individual can earn a week and still qualify for a card. It is specific to the individual’s own financial circumstances.

Persons aged 69 and under are assessed under the general means tested medical card thresholds which are based on an applicant’s household income after tax and the deduction of PRSI and the Universal Social Charge. Certain expenses are also taken into account, i.e. mortgage payments, which help to increase the amount a person can earn and still qualify for a medical card.

Persons aged 70 or older are assessed under the over 70s medical card income thresholds which are based on gross income. It should also be noted that since November 2020, the weekly gross medical card income thresholds for those aged 70 and over were increased to €550 per week for a single person and €1050 for a couple. This increase ensures that a greater proportion of those aged 70 and over now qualify for a medical card.

I wish to assure the Deputy that the current medical card income thresholds are kept under regular review and any changes are considered in the context of Government policy, the annual budgetary estimates process and other issues which may be relevant.

Hospital Appointments Status

Questions (296)

Bernard Durkan

Question:

296. Deputy Bernard J. Durkan asked the Minister for Health if an appointment will be expedited in the case of a person (details supplied); and if he will make a statement on the matter. [8880/22]

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Written answers

Minister for Health

Under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.

In relation to the particular query raised, as this is a service matter, I have asked the Health Service Executive to respond to the deputy directly, as soon as possible.

Registration Certificate

Questions (297)

Dessie Ellis

Question:

297. Deputy Dessie Ellis asked the Minister for Health the wait times for appointments for registering a birth and registering a death; and if he will make a statement on the matter. [8894/22]

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Written answers

Minister for Health

As this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.

Disabilities Assessments

Questions (298, 301, 302, 303, 304, 305, 306, 307, 308, 309, 310, 311, 312, 313)

Disabilities Assessments

Questions (299, 300)

Mary Lou McDonald

Question:

299. Deputy Mary Lou McDonald asked the Minister for Health the number of complaints received in each of the years 2016 to 2022 regarding the failure to carry out an assessment of need in line with standards in each CHO area; and the number of complaints that were upheld in tabular form. [8903/22]

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Mary Lou McDonald

Question:

300. Deputy Mary Lou McDonald asked the Minister for Health the number of complaints officers who are currently employed to deal with assessment of need related complaints in each CHO area; and the location of each; and if he will make a statement on the matter. [8904/22]

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Written answers

Minister of State at the Department of Health

I propose to take Questions Nos. 299 and 300 together.

As the Deputy's questions relate to service issues, they have been referred to the HSE for direct reply, as soon as possible.

Question No. 300 answered with Question No. 299.

Question No. 301 answered with Question No. 298.

Question No. 302 answered with Question No. 298.

Question No. 303 answered with Question No. 298.

Question No. 304 answered with Question No. 298.