Tuesday, 22 Feb 2022

Written Answers Nos. 711-730

Health Service Executive

Questions (711)

Duncan Smith

Question:

711. Deputy Duncan Smith asked the Minister for Health if his Department has knowingly set staffing targets and funding for the HSE that are undeliverable; and if he will make a statement on the matter. [9233/22]

Written answers

Minister for Health

Budget 2022 secured funding for up to an additional 10,000 WTE, reflecting the level of ambition and desire to invest in our health services. However, there are a range of targets set out in the draft National Service Plan. The targeted recruitment for this year continues to address any identified staff shortages across grades and service areas.

Discussions between the Department and HSE officials agreed that, due to the current challenging recruitment environment, 5,500 WTE is a more achievable target for 2022. The upper affordable limit of 10,000 WTE is not seen as undeliverable, but rather one that will be ambitious and challenging to achieve, given the risks affecting labour supply. It is worth noting that these recruitment targets are additional WTE and do not include the replacement of existing staff who retire/leave during the year.

The HSE identified the more realistic recruitment target of 5,500 WTE alongside a more challenging ‘stretch’ target of 10,000 WTE set out in the National Service Plan. The Department has been working closely with the HSE to assess potential savings and further decisions on how this funding will be used will be taken. Actual recruitment will, as always, be monitored by the HSE and the Department throughout the course of the year under the governance and oversight arrangements in place.

Dental Services

Questions (712)

Martin Browne

Question:

712. Deputy Martin Browne asked the Minister for Health further to Parliamentary Question No. 1399 of 24 March 2021, the progress made in reviewing the dental treatment services scheme; the result of engagements he has had with the dental community in this regard; and if he will make a statement on the matter. [9241/22]

Written answers

Minister for Health

I have given a commitment to a substantive review of the Dental Treatment Services Scheme (DTTS), which will include fees paid to dentists. I have also acknowledged the immediate issues of concern with current arrangements under the Scheme.

Officials from my Department and from the HSE have held two rounds of discussions with the Irish Dental Association, the most recent on 17 December last when my Department and the HSE presented proposals to invest additional resources in the DTTS including €10m provided in the Budget, on top of the 2022 Estimate allocation of €56 million.

The Department/HSE has offered increased fees across a number of items and proposed the reintroduction of the Scale and Polish item.

These proposals were expedited to address not only the problem of access for patients, but also concerns expressed by dentists about the viability of the DTSS, and to some extent, to bring about alignment with the Dental Treatment Benefits Scheme, which is widely operated by dentists for PRSI patients.

The Department wishes to move the process on, in the interests of patients, and is hoping to meet the Irish Dental Association again in the next couple of weeks to progress matters.

Hospital Appointments Status

Questions (713)

Darren O'Rourke

Question:

713. Deputy Darren O'Rourke asked the Minister for Health when a person (details supplied) in County Meath will receive an appointment at the National Rehabilitation Hospital; and if he will make a statement on the matter. [9242/22]

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, as soon as possible.

Legislative Measures

Questions (714)

Duncan Smith

Question:

714. Deputy Duncan Smith asked the Minister for Health the legal advice he has received in regard to the drafting of legislation for safe access zones; and if he will make a statement on the matter. [9250/22]

Written answers

Minister for Health

As the Deputy will be aware, legal advice is confidential and privileged. My responses to the Deputies during Committee Stage of the Safe Access to Termination of Pregnancy Services Bill 2021 gave an overview of the legal advice provided to me and are a matter of Seanad record.

Disability Services

Questions (715)

Eoin Ó Broin

Question:

715. Deputy Eoin Ó Broin asked the Minister for Health the number of psychiatric services for adults with ASD in the HSE, broken down by region; and his plans to expand these services. [9252/22]

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 directly to the Deputy as soon as possible.

Departmental Inquiries

Questions (716)

Paul Murphy

Question:

716. Deputy Paul Murphy asked the Minister for Health if his attention has been drawn to the recent revelation in the media (details supplied) that a critical peer review by a person of a key section of the Askeaton Inquiry Report was not published at the time of the report in 2001; if an inquiry will be conducted into the reason this happened; and if he will make a statement on the matter. [9258/22]

Written answers

Minister for Health

I am satisfied with the findings of the Askeaton Inquiry Report and therefore do not propose to have any further inquires conducted into the matter.

Dental Services

Questions (717)

Eoin Ó Broin

Question:

717. Deputy Eoin Ó Broin asked the Minister for Health the status of the provision of primary school dental services in areas of mid-west Dublin; the waiting times and availability of dentists visiting primary schools in the area in tabular form; and if he will make a statement on the matter. [9259/22]

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.

Dental Services

Questions (718)

Eoin Ó Broin

Question:

718. Deputy Eoin Ó Broin asked the Minister for Health the waiting lists for dental checks for children at six, nine and 12 years of age in the mid-west areas of Dublin in tabular form; if there are delays in children receiving these checks; the steps he is taking to ensure that these children receive checks in a timely manner; and if he will make a statement on the matter. [9260/22]

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.

Home Care Packages

Questions (719, 720, 721, 722)

John Lahart

Question:

719. Deputy John Lahart asked the Minister for Health the steps he is taking to standardise home care rates of pay and benefits across Ireland (details supplied). [9261/22]

John Lahart

Question:

720. Deputy John Lahart asked the Minister for Health the steps that are being taken to ensure better terms and conditions will be provided to enable Alzheimer's organisations (details supplied) to retain home care staff; and if he will make a statement on the matter. [9262/22]

John Lahart

Question:

721. Deputy John Lahart asked the Minister for Health if he is considering increasing the funding for organisations (details supplied) to operate a buddy system or to allow new starters to work alongside more experienced staff for a meaningful period of time. [9263/22]

John Lahart

Question:

722. Deputy John Lahart asked the Minister for Health his views on the need for a review to provide a balance between State providers of home care services and their NGO and private sector counterparts (details supplied); and if he will make a statement on the matter. [9265/22]

Written answers

Minister of State at the Department of Health

I propose to take Questions Nos. 719 to 722, inclusive, together.

The Government is committed to improving community-based services, shifting care to the home, and offering greater choice for older people.

During the lifetime of this Government, I have secured additional funding of €150 million for home support, to progress the development of a reformed model of service delivery to underpin the statutory scheme for the financing and regulation of home support services, and to provide for up to 5 million additional hours of home support last year.  Funding for these additional hours has been maintained into 2022.  

Preliminary data shows that about 2.9 million more home support hours were delivered by the end of December 2021, compared to the same period in 2020. 

I am aware that delays can arise between funding approval and the delivery of home support hours. Certain regions are experiencing increased pressures due to staff availability. 

I am committed to establishing a cross-Departmental Strategic Workforce Advisory Group to examine strategic workforce challenges, including recruitment and retention of workers, in front-line carer roles in home support and nursing homes.   This will include those home support workers providing support to those with Alzheimer's.

The work of this Group will centre on engagement with the relevant stakeholders in the sector.  To this end, a 'Call for Submissions' was issued by my Department to relevant stakeholders in December 2021.  Following receipt of these completed submissions in January, my Department undertook a short-life scoping exercise to gather initial data and evidence on the nature and extent of the challenges in the sector to inform the structure and membership of this cross-departmental Group.

This scoping exercise is now complete and invitations to join the Group, along with its draft Terms of Reference, have been issued to all relevant Government Departments and agencies.  The inaugural meeting of the Group will be held in the week beginning 28th February 2022. 

At this meeting, the Terms of Reference for the Group and action timelines will be agreed. These Terms of Reference will be published once finalised by the Group.

This Group will then progress a structured programme of ongoing consultative engagements with key sectoral stakeholders to further explore and define the issues, listen to stakeholder views, and identify approaches to respond to the strategic workforce challenges.

The Group will provide a forum for agreement on strategic approaches to address the workforce challenges in the sector and develop a report for my consideration outlining the Group’s key findings, recommendations, and a proposed action plan to support implementation of these recommendations to include periodic monitoring of progress.

Potential areas to be considered by the Group include recruitment, retention, training, and the career development of front-line carers in home support and nursing homes into the future.  It is also expected that pay and conditions for these workers will be examined.  Without pre-empting the outcomes of the work of the Group, the buddy system mentioned by the Deputy may emerge as a solution to address the challenges in the sector, however it is too soon to say at this time.

Question No. 720 answered with Question No. 719.

Question No. 721 answered with Question No. 719.

Question No. 722 answered with Question No. 719.

Health Services Staff

Questions (723)

David Cullinane

Question:

723. Deputy David Cullinane asked the Minister for Health the number of consultant applications advisory committee approved consultant posts on 1 January in each of the years 2016 to 2022. [9286/22]

Written answers

Minister for Health

Given its statutory functions in relation to approval of consultant posts I have asked the HSE to reply directly to the Deputy concerning the data sought.

Disease Management

Questions (724)

Paul Murphy

Question:

724. Deputy Paul Murphy asked the Minister for Health the status of plans for improving podiatry services for persons in south-west Dublin and nationally in relation to the HSE model of care for the diabetic foot (details supplied). [9293/22]

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.

Dental Services

Questions (725)

Pa Daly

Question:

725. Deputy Pa Daly asked the Minister for Health the action he will take to ensure that medical card holders in County Kerry are able to access dental care given that the HSE has stated there are no dentists taking on new medical card patients in the county; and if he will make a statement on the matter. [9298/22]

Written answers

Minister for Health

The Dental Treatment Services Scheme (DTTS), which dates from the 1990s is available to medical card holders aged 16 and over. The dental care is provided by independent dental practitioners who have a contract with the HSE. Patients may choose to have their treatment undertaken by any dentist who participates in the scheme. The Scheme covers a dental examination, two fillings in each calendar year, prescriptions, denture repairs and extractions as necessary. Other more complex treatments such as the provision of dentures require the approval of the HSE before the dentist can proceed and in this case the dentist applies directly to the HSE.

There is a need to align the DTSS with best international evidence and practice, and legislation, as outlined in Smile agus Sláinte, the National Oral Health Policy. Regretfully, the COVID-19 pandemic caused the roll-out of the Policy to be delayed and the proposed review of the DTSS contract to be deferred.

It is regrettable that a significant number of dentists chose to leave the DTSS that provides care for medical card patients during the pandemic, which has led to difficulties for medical card patients in accessing dental care in some parts of the country. In such circumstances, I have been assured that the HSE Public Dental Service is seeking to provide emergency cover for any medical card patients who are experiencing such problems.

I have given a commitment to a substantive review of the DTSS, which will include fees paid to dentists. I have also acknowledged the immediate issues of concern with current arrangements under the Scheme.

My officials met with the Irish Dental Association in December to address both of these issues. It is the intention of my officials to hold further talks in Q1 of this year.

I would also wish to point out that I secured additional funding of €10 million in Budget 2022 to address immediate issues with the DTSS, which is on top of the annual allocation of €56 million for 2022.

Question No. 726 answered with Question No. 664.

Question No. 727 answered with Question No. 664.

Healthcare Policy

Questions (728)

Duncan Smith

Question:

728. Deputy Duncan Smith asked the Minister for Health the status of the roll-out of free contraception for 17- to 25-year-olds; when he expects free contraception to be made available; and if he will make a statement on the matter. [9304/22]

Written answers

Minister of State at the Department of Health

The Report of the Working Group on Access to Contraception, published in October 2019, identified the barriers that exist to accessing contraception, which include accessibility, information, workforce capacity and, for a significant number of women who may be just above the eligibility threshold for a full GMS (medical) card, cost.

In consideration of the recommendations of the Joint Oireachtas Committee on the 8th Amendment to the Constitution (JOC8) and the findings of the Working Group on Contraception, the Programme for Government, 2020 commits to providing free contraception for women, starting with the 17-25 age cohort.

Work on this was temporarily delayed by the Covid-19 pandemic, but the cross-disciplinary Contraception Implementation Group was set up in July 2021 to progress the introduction of this scheme.

The Contraception Implementation Group meets on a monthly basis, with small sub-groups also meeting with counterparts in the HSE to ensure that steady progress is being made on implementation. Funding of approximately €9m has been allocated in Budget 2022 to enable commencement of the scheme, which is scheduled for August 2022.

The scheme will provide for:

1. The cost of prescription contraception;

2. The cost of two consultations per annum with GPs and other doctors to discuss suitable contraception for individual patients and to enable prescription of same;

3. The cost of fitting and/or removal of various types of long-acting reversible contraception (LARCs) plus any necessary checks, by medical professionals certified to fit/remove same;

4. The cost of training and certifying additional medical professionals to fit and remove LARCs;

5. Provision of contraceptive options currently available to GMS (medical) card holders through this scheme, to include contraceptive injections, implants, IUS and IUDs (coils), the contraceptive patch and ring, and various forms of oral contraceptive pill, including emergency contraception.

For items such as the contraceptive pill, these are typically prescribed at 6 month intervals, so two consultations allows for full provision. For LARCs, (e.g. IUS, IUD, implants, injections, patches and rings), where the fittings/injections are carried out by healthcare professionals, fitting and removal appointments are also provided for separately, in addition to the two consultations.

Work on the legislative framework for the scheme is ongoing. Formal negotiations with medical and other relevant representative bodies with regard to service provision are due to commence in March 2022.

As part of the allocation of funding for the scheme that was provided for in Budget 2022, funds are being made available for additional training capacity with respect to certification of medical professionals to fit and remove LARCs. Engagement with the HSE in relation to this is ongoing.

Medicinal Products

Questions (729, 793)

David Cullinane

Question:

729. Deputy David Cullinane asked the Minister for Health if his attention has been drawn to the shortage of hormone replacement therapy in the Republic of Ireland; the steps he has taken to address the shortages; if he has engaged with his counterpart in Northern Ireland in relation to same; and if he will make a statement on the matter. [9305/22]

Mary Lou McDonald

Question:

793. Deputy Mary Lou McDonald asked the Minister for Health the reason for shortages in HRT medicines given that The Health Products Regulatory Authority has listed these as medicines shortages; the measures that are in place to minimise impact or disruption to patient care and the impact on healthcare professionals caused by these shortages; and if he will make a statement on the matter. [9602/22]

Written answers

Minister for Health

I propose to take Questions Nos. 729 and 793 together.

Medicine shortages have become increasingly prevalent worldwide over the past decade and are a feature of modern health systems around the world. There are many reasons for such shortages including shortages of raw materials, manufacturing difficulties, logistical/transport issues or product recalls due to potential quality defects. Medicines shortages can therefore originate at any point in the supply chain and can involve and impact on many different stakeholders. Accordingly, medicines shortages require a multi-faceted, multi-stakeholder response to ensure patient safety, continuity of care and protection of public health.

As a result of the increasing prevalence of medicines shortages globally, there has been significant interest at European level in this area, including a task force on medicines availability to identify and address issues linked to the disruption of supplies of medicines. Ireland, through my Department and the Health Products Regulatory Authority, continues to contribute to these efforts at a European level to consider initiatives to minimise the risk and disruption to patient safety and care, and the impact on healthcare professionals, caused by medicine shortages. As well, colleagues within the Department continue to engage with their counterparts in Northern Ireland in order to better address health concerns across the island.

At a national level, Ireland has a multi-stakeholder medicines shortages framework in place, coordinated by the Health Products Regulatory Authority (HPRA), to prevent, wherever possible, and manage medicine shortages when they occur. The HPRA have been notified of intermittent supply challenges involving HRT medicines that have been ongoing for some months. These supply difficulties are due to a significantly increased demand for theses products in Ireland in recent years. The HPRA continues to engage with the companies involved to mitigate the impact of the shortages.

In the case of medicines used most often in Ireland, there are typically multiple brands and/or generic medicines available from a range of sources. In the event that supply issues arise for individual medicines, different options, including alternative brands or generic medicines, should be made available to ensure continuity of treatment. If the patient has concerns, they should discuss their treatment and alternative options with their doctor, pharmacist or other healthcare professional.

Primary Care Services

Questions (730)

Michael McNamara

Question:

730. Deputy Michael McNamara asked the Minister for Health the number of days per week the new lymphoedema specialist clinic in Ennis, County Clare was in operation in 2021; the number of patients currently awaiting appointments at the lymphoedema clinic; the length of the waiting times for patients; and if he will make a statement on the matter. [9313/22]

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.