Written Answers Nos. 663-683
663. Deputy Peadar Tóibín asked the Minister for Health the number of investigations, internal or external, commissioned by his Department into instances in which Departmental documents or information was leaked to the media, which were commissioned or conducted in each of the past ten years and to date in 2022; the nature of such leaks and investigations; and if he will make a statement on the matter. [26340/22]
View answerWhere appropriate, the Department applies the provisions of the Civil Service Disciplinary Code for matters of the nature set out in the Deputy's question.
Workplace investigations undertaken under the Civil Service Disciplinary Code are by their nature confidential.
In line with the Records Retention Schedule for the Civil Service as set out by the National Archives, the Department only retains records for the time periods permitted. The Department does not maintain a list or record of the number or nature of investigations undertaken.
664. Deputy David Cullinane asked the Minister for Health if he has engaged with his counterpart in the Northern Ireland Executive to extend arrangements for the provision of access to healthcare services in the State for residents of Northern Ireland; and if he will make a statement on the matter. [26356/22]
View answerHealthcare co-operation with Northern Ireland covers a range of areas and there is ongoing communication between officials in my Department and their counterparts in Northern Ireland. I have also met Minister Swann a number of times since I became Minister for Health.
There are agreements in place covering specific specialist treatments on a cross-border basis, including elective and urgent cardiac surgical cases from Northern Ireland being treated in Children’s Health Ireland at Crumlin and, in the opposite direction, the North West Cancer Centre (Radiotherapy Unit) at Altnagelvin Area Hospital in Derry is providing access to radiotherapy services for people in the north west of the island including patients from Ireland.
The Health Act 1970 (as amended) provides for two categories of eligibility for persons ordinarily resident in the country, i.e. full eligibility (medical card holders) and limited eligibility (all others).
The EU-UK Trade and Cooperation Agreement concluded between the EU and the UK includes provisions relating to social security and health rights for certain categories of persons. Social security and healthcare rights are also provided for by the EU-UK Withdrawal Agreement.
I am committed to continuing close and productive cooperation with Northern Ireland.
665. Deputy Jackie Cahill asked the Minister for Health when the occupational therapist position in Templemore CHO area 3 will be filled given that it has remained vacant since February 2022 (details supplied); and if he will make a statement on the matter. [26383/22]
View answerAs the Deputy's question relates to a service matter, it has been referred to the HSE for direct reply.
666. Deputy David Cullinane asked the Minister for Health the number of occasions on which HSE employees have been docked pay for being late; the number that were late by less than 30 minutes; the number by less than 15 minutes; the number by less than 5 minutes, for each month of 2020 and 2021 and 2022 to date in tabular form; and if he will make a statement on the matter. [26386/22]
View answerI have asked the HSE to respond directly to the Deputy on this matter.
667. Deputy Niamh Smyth asked the Minister for Health if he will expedite a hospital appointment for a person (details supplied); and if he will make a statement on the matter. [26387/22]
View answerUnder 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.
668. Deputy Sean Fleming asked the Minister for Health the expected timescale of the recruitment process for a position (details supplied); and if he will make a statement on the matter. [26401/22]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
669. Deputy Niall Collins asked the Minister for Health further to Parliamentary Question No. 316 of 17 February 2022, the current staffing levels of paediatric epilepsy services at University Hospital Limerick; the current vacancies which exist in the service; the measures that are being taken to recruit staff for these services; and if he will make a statement on the matter. [26402/22]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
670. Deputy Patrick Costello asked the Minister for Health if there is any process whereby a person can reclaim the cost of medication which has now been reimbursed by the HSE (details supplied); and if he will make a statement on the matter. [26406/22]
View answerAs the Health Service Executive (HSE) has statutory responsibility for decisions on pricing and reimbursement of medicines, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013, I have asked the HSE to respond to the Deputy directly, as soon as possible.
671. Deputy Niamh Smyth asked the Minister for Health if he will provide a list of the public health nurses operating in the relevant areas in counties Cavan, Monaghan and Meath in tabular form; the locations in which there are vacancies at present; the length of time these posts have been vacant; and the plans and timeframes that are in place to find suitable replacements. [26428/22]
View answerIn 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.
672. Deputy Niamh Smyth asked the Minister for Health if he will review matters raised in correspondence by a person (details supplied); if the public health nursing position has been filled on a permanent basis in Killeshandra, County Cavan; and if he will make a statement on the matter. [26429/22]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
673. Deputy Fergus O'Dowd asked the Minister for Health the status of the development of a well-governed and patient-centred healthcare service by the HSE for adults and children in the transgender community, in line with the Programme for Government; and if he will make a statement on the matter. [26435/22]
View answerThe Programme for Government commits to create and implement a general health policy for Trans people, based on a best-practice model for care, in line with the World Professional Association of Transgender Healthcare (WPATH) and deliver a framework for the development of national gender clinics and multidisciplinary teams for children and adults.
The HSE is committed to developing services for the transgender community in accordance with international best practice across a number of programmes including mental health, acute hospitals and primary care. This includes a robust and agreed care pathway for young people with gender dysphoria, in line with international best practice.
I am advised that a model of care for transgender children, adolescents and adults has been developed by the HSE Quality Improvement Division. The model recommends a comprehensive multidisciplinary psychosocial assessment prior to commencement of hormone therapy by endocrinology services, and also outlines the framework for the development of National Gender Clinics and MDTs for children and adults.
The Office of the National Clinical Advisor & Group Lead for Mental Health is involved in ongoing discussions with the HSE Treatment Abroad Scheme in order to identify alternative gender identity clinics abroad that would facilitate referral for under 16's, with particular reference to the psychology assessment component of the care pathway, pending the development of a national child and adolescent service. This is to fill a gap created by the suspension of a referral system to a UK service that had been in place for under 16's. Fidelity with the clinical model of care approved by the HSE is essential in advance of considering alternative referral routes.
While there are definite challenges in responding to the needs of this population, there have been many positive developments: -
- embedded clinical services, with expertise, in certain parts of the country,
- constructive advocacy groups in place with both individual and family experience of this issue,
- funding for a number of posts exists, and
- development of a model of care.
The challenges mainly centre around operational and governance issues which reflect the fact that the health services are delivered by a range of voluntary and statutory services and have grown up along with demand and clinician-led responses.
I am committed to the development by the HSE of a well-governed and patient-centered health care service for adults and children in the transgender community, in line with the Programme for Government.
674. Deputy Fergus O'Dowd asked the Minister for Health the position of his Department in respect of the Regulation of Homecare paper published by the Health Information and Quality Authority; if the paper will be used by his Department to progress the development of the new statutory home support scheme as part of the Sláintecare programme; and if he will make a statement on the matter. [26437/22]
View answerThe HIQA paper on the regulation of homecare services published in December 2021 makes a valuable contribution to the development of the new statutory scheme for the financing and regulation of home-support. It will further inform progress on the Sláintecare programme, which aims to support people to live in their own homes with dignity and independence, for as long as possible.
The Government is committed to establishing a new, statutory home-support scheme, which the Department of Health is currently developing. The new scheme will provide equitable and transparent access to high-quality services for people based on their assessed care-needs.
This work encompasses the development of the regulatory framework for the new scheme; the examination of the options for the financing model for the scheme; and the development of a reformed model of service-delivery for home-support services. With the aim of ensuring that all service-users are provided with a standard, high-quality level of care which is safe, effective, and person-centred, it is envisaged that the regulatory framework will comprise: (i) primary legislation for the licensing of public and private home-support providers; (ii) minimum requirements (i.e., regulations); and (iii) HIQA National Standards for Home Support Services.
Last year, Government gave approval to draft a General Scheme and Heads of a Bill to establish a licensing framework for home-support providers. This is being progressed by the Department with a view of bringing it through the Houses of the Oireachtas at the earliest opportunity. It is expected that the primary legislation will give the Minister for Health the power to make regulations in respect of minimum requirements which will form the criteria against which a provider’s eligibility to hold a licence will be determined. A regulatory impact analysis will be undertaken by the Department in 2022 to ensure effectiveness and mitigate risks.
The aim is to ensure that service-users are safe-guarded and protected, and a responsive, person-centred, quality-driven home-support service is provided. This is central to the Sláintecare objective of providing ‘right care, in the right place at the right time’. The regulations being drawn up by the Department and the standards being drafted by the HIQA both take cognisance of the diverse and often complex needs of those who require homecare and support.
HIQA has extensive experience in the regulation of social care services and has conducted wide-ranging research into the regulation of home-support services. HIQA ran a public scoping consultation in September 2021 to inform the development of National Standards for Home Support Services. HIQA has convened an Advisory Group, with representation from the Department of Health, to assist in the process of developing the Draft National Standards.
In collaboration with HIQA and in consultation with the Health Service Executive and other key informants, the Department developed draft regulations and a targeted stakeholder consultation was undertaken in January 2022. Evaluating the feedback of this consultation is informing amendments in the draft regulations in advance of a public consultation planned in Q2 2022.
The Pilot for testing of a reformed model of service for the delivery for home-support is fully operational. It commenced in November in CHO 8, which is the first of the four pilot sites. The three other sites CHO2, CHO 4 and CHO 7 became operational in January 2022. Funding has been approved for 128 interRAI Care Needs Facilitators to progress the national roll-out of interRAI as the standard assessment tool for care-needs. The interRAI outputs and pilot site evaluation will be critical to the development of the new home-support scheme. A National Home Support Office is in the process of being established.
675. Deputy Fergus O'Dowd asked the Minister for Health the status of the provision of transitional plans to ensure that young persons with a disability who wish to reside outside of nursing home settings and who wish to live independently have sufficient choice and options available to them; and if he will make a statement on the matter. [26439/22]
View answerNursing homes are an appropriate care option where the person concerned has a clinically assessed complex medical and social care requirement which cannot be supported in the person’s home. However, for some people under the age of 65 years, nursing homes are not an appropriate placement and alternative, more sustainable supported living solutions, are needed to give them greater independence and choice in their daily lives.
According to the HSE there is a cohort of approximately 1,330 people under 65 years of age living in nursing homes, 45% of whom are aged 60+ and 20% less than 50 years. For many a nursing home may be the appropriate setting based on their clinical and support needs. However, the HSE acknowledges that this must be the subject of a care and case management approach that facilitates structured reviews and where the will and preference of the individual is of paramount importance.
There is a clear Government commitment to reduce and provide a pathway to eliminate the practice of accommodating young people with serious disabilities in nursing homes.
A range of measures are supported by the HSE National Service Plan (NSP) to enable people under 65 to move from nursing homes as well as to provide supports to those who wish to remain at home. The aim is to prevent people under 65 inappropriately entering nursing homes in the first instance.
The HSE NSP 2021 provided for an investment of €3m to enable 18 people under the age of 65 years to move from nursing homes. 14 of the 18 have been moved, with work ongoing to move a further 4 people. Budget 2022 provided a further allocation of €5.5m to work with a further 63 people with a view to transferring them from nursing homes.
In relation to the transition plans, HSE CHOs are currently working with people on the ground to develop the plans and deliver choice.
Measures to prevent young persons from entering nursing homes continue to be supported through a range of services including intensive support packages, respite, home support, and personal assistance services.
676. Deputy Fergus O'Dowd asked the Minister for Health the status of the proposed east Meath primary care centre which is to be located in Bettystown town centre; when he expects work to commence; if other relevant details in this regard will be provided; and if he will make a statement on the matter. [26441/22]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
677. Deputy Fergus O'Dowd asked the Minister for Health the current status of the proposed Dundalk primary care centre; and if he will make a statement on the matter. [26443/22]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
678. Deputy Fergus O'Dowd asked the Minister for Health if he will report on the progression of the new 50-bed hospital in St. Joseph's Hospital, Ardee, County Louth; if he will provide other relevant details in relation to same; and if he will make a statement on the matter. [26457/22]
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.
679. Deputy David Cullinane asked the Minister for Health the number of acute inpatient beds in the public healthcare system per 1,000; the total number; the way in which this compares with other Organisation for Economic Co-operation and Development and European Union states, in tabular form; and if he will make a statement on the matter. [26461/22]
View answerPlease find attached excel showing acute beds per 1,000 population Ireland and OECD countries for which data is available, also a second excel showing total number of curative (acute) beds in Ireland and various other Eurostat countries. Data in the first is available at: data.oecd.org/healtheqt/hospital-beds.htm. Data in the second is at
ec.europa.eu/eurostat/databrowser/view/hlth_rs_bds/default/table?lang=en.
680. Deputy David Cullinane asked the Minister for Health the number of critical care beds in the public healthcare system per 100,000; the total number; the way in which this compares with other Organisation for Economic Co-operation and Development and European Union states in tabular form; and if he will make a statement on the matter. [26462/22]
View answerThe Irish National ICU Audit Interim Report 2019, published by the National Office of Clinical Audit (NOCA) in 2020, reported that Ireland had 5.2 critical care beds in public hospitals per 100,000 population, less than half the European average. The deficit in critical care capacity in the Irish acute hospital system was also identified in the 2018 Health Service Capacity Review, which recommended that critical care capacity be increased to 430 beds by 2031.
The Government is committed to addressing this long-standing deficit in critical care capacity. Very significant funding of €77 million has been provided by Government across 2021 and 2022, to increase national capacity to 340 critical care beds by 2023.
The HSE has advised that 51 of these beds are now open, bringing permanent adult critical care capacity to 306 beds currently, from the 2020 baseline of 255 or an increase of 20% over the 2020 baseline of 255 beds.
The Strategic Plan for Critical Care, which I brought to Government in December 2020, will when implemented fully address the critical care recommendations of the Health Service Capacity Review. In fact, it surpasses that recommendation, delivering an increase in capacity to 446 over time.
With regard to how our critical care capacity compares with other jurisdictions, the OECD Health at a Glance 2021 Report shows how Ireland compares with other OECD nations and can be found at the following link: read.oecd.org/10.1787/e5a80353-en?format=read#page2.
681. Deputy David Cullinane asked the Minister for Health the number of subacute inpatient beds in the public healthcare system per 1,000; the total number; the way in which this compares with other Organisation for Economic Co-operation and Development and European Union Member States in tabular form; and if he will make a statement on the matter. [26464/22]
View answerPlease find attached excel showing acute beds per 1,000 population Ireland and OECD countries for which data is available, also a second excel showing total number of curative (acute) beds in Ireland and various other Eurostat countries.
Data in the first is available at: data.oecd.org/healtheqt/hospital-beds.htm. Data in the second is at: ec.europa.eu/eurostat/databrowser/view/hlth_rs_bds/default/table?lang=en.
This is the only hospital bed related data sent by the Department of Health to OECD/Eurostat.
682. Deputy David Cullinane asked the Minister for Health the number of subacute community beds in the public healthcare system per 1,000; the total number; the way in which this compares with other Organisation for Economic Co-operation and Development and European Union in tabular form; and if he will make a statement on the matter. [26465/22]
View answerAs this is a service matter, I have asked the Health Service Executive to respond to the Deputy directly, as soon as possible.
683. Deputy Sorca Clarke asked the Minister for Health the steps that he and his Department are taking to tackle the continued shortage of hormone replacement treatments across the country; and if he will make a statement on the matter. [26470/22]
View answerUnfortunately, 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 multifaceted, multi-stakeholder response to ensure patient safety, continuity of care and protection of public health. 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 is aware of the current challenges regarding the intermittent supply of some hormone replacement therapies (HRT). The HPRA has had regular and ongoing engagement with suppliers in this regard. The companies that place the products on the market have indicated that the current supply difficulties are due to a significantly increased demand for these medicines in Ireland in recent years. To illustrate, the supply of one range of HRT patches has increased by between 77% and 117%, for the three most-used strengths, compared to 2020. In addition, based on demand in recent months, the company expects a similar increase in the demand for all strengths during 2022. This would mean that the usage of this patch in Ireland would be approximately 4.5-7.5 times higher in 2022 (depending on the strength) compared to 2019.
Based on information provided by companies involved in the recent HRT shortages, we now appear to have entered a stabilisation period in supply. During this stabilisation period, it is essential that patients do not seek supplies of medicines over and above their normal requirements as doing so will disrupt existing stock levels and hamper the supply of medicines for others. Following a meeting with key stakeholders involved in the supply of HRT products to the Irish market it was agreed to establish a multi-stakeholder group to closely monitor the supply of HRT until the issue is fully resolved.
The HPRA publishes a medicinal product shortages list on its website, with the reason for the shortage, the expected dates for the return of supply and in some cases, such as HRT shortages, the HSE’s clinical guidance on the management of patient treatment in response to medicine shortages. The information is made available to assist healthcare professionals in managing medicine shortages when they do arise and reduce their impact on patients. The information relating to shortages on the HPRA website is dynamic and changes depending on the current information the HPRA has to hand, including removal from the list when a shortage has been resolved.
The HPRA will continue to liaise with suppliers of HRT medicines over the coming weeks with a view to securing updates and commitments regarding the restoration of normal supplies for patients as soon as possible.
