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Tuesday, 31 May 2022

Written Answers Nos. 715-734

Hospital Transfers

Questions (717)

Matt Shanahan

Question:

717. Deputy Matt Shanahan asked the Minister for Health Further to Parliamentary Question Nos. 1849, 1850 and 1851 of 26 April 2022, the communications that have taken place between his Department and the steering leads compiling the Nolan Report in relation to the future configuration of cardiac care services; if the three year transfer times have been fully communicated to the authors of the report; if they have been advised that these transfers relate to a number of stemi heart attacks; and if he will make a statement on the matter. [27753/22]

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Written answers

Access to care at the right time is critical to ensure that cardiovascular conditions are well managed. In the acute setting, access to primary percutaneous intervention (PPCI), or where that is not available in the recommended timeframe, thrombolysis (clot busting), can reduce the likelihood of myocardial (heart attack) damage, and therefore subsequent poor health outcomes.   

The National Review of Specialist Cardiac Services commenced in January 2018 under the Chairmanship of Professor Phillip Nolan and a Steering Group formed from nominations of interested stakeholders representing medical, professional/technical staff, nursing, and patient representatives. The National Review of Specialist Cardiac Services is examining the delivery of cardiac services nationally with the aim of ensuring that as many patients as possible have access, on a 24/7 basis to safe, quality assured and sustainable emergency interventions following an acute myocardial infarction.  The Review seeks to achieve optimal patient outcomes at population level with particular emphasis on the safety, quality, and sustainability of the services that patients receive by establishing an optimal configuration of a national adult cardiac service. The review is underpinned by a rigorous systematic evidence review, data analysis of existing service provision, and examination of relevant international good practice. The most up to date information and data available including the recent NOCA Heart Attack Audit is considered as part of the review process. 

The Steering Group is currently working on the development of the proposed recommendations of the draft Report with the next meeting planned for late June 2022. The Steering group most recently met on the 26th of May 2022 to further progress the review.  The implementation process for the National Cardiac Services Review is also being developed as part of the process to finalise the Report. Decisions on further service developments will await the final Report and recommendations of the National Review of Specialist Cardiac Services.   

Question No. 718 answered with Question No. 714.

Departmental Reports

Questions (719)

Matt Shanahan

Question:

719. Deputy Matt Shanahan asked the Minister for Health the reason for the delay in the receipt of a report (details supplied); if he will guarantee a date for the report to be reviewed by his Department and for its recommendations to be discussed with Members of the Houses of the Oireachtas from County Waterford as part of the commitment given by him and another person at the meeting; and if he will make a statement on the matter. [27755/22]

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Written answers

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

Departmental Reports

Questions (720)

Matt Shanahan

Question:

720. Deputy Matt Shanahan asked the Minister for Health the date for receipt of a report (details supplied); if a date will be provided for a subsequent meeting with members of the Houses of the Oireachtas from the south east which was promised by him at meeting on 29 March 2022; and if he will make a statement on the matter. [27756/22]

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Written answers

The National Review of Specialist Cardiac Services commenced in January 2018 under the Chairmanship of Professor Phillip Nolan and a Steering Group formed from nominations of interested stakeholders representing medical, professional/technical staff, nursing, and patient representatives. The National Review of Specialist Cardiac Services is examining the delivery of cardiac services nationally with the aim of ensuring that as many patients as possible have access, on a 24/7 basis to safe, quality assured and sustainable emergency interventions following an acute myocardial infarction.  The Review seeks to achieve optimal patient outcomes at population level with particular emphasis on the safety, quality, and sustainability of the services that patients receive by establishing an optimal configuration of a national adult cardiac service. The review is underpinned by a rigorous systematic evidence review, data analysis of existing service provision, and examination of relevant international good practice. 

The Steering Group is currently working on the development of the proposed recommendations of the draft Report with the next meeting planned for June 2022. The Steering group most recently met on the 26th of May 2022 to further progress the review.  The implementation process for the National Cardiac Services Review is also being developed as part of the process to finalise the Report. Decisions on any subsequent meetings and / or further service developments will await the final Report and recommendations of the National Review of Specialist Cardiac Services.   

Question No. 721 answered with Question No. 714.

Hospital Transfers

Questions (722)

Matt Shanahan

Question:

722. Deputy Matt Shanahan asked the Minister for Health the reason for the difference between the way that a heart attack or cardiac arrest patient attending the National Maternity Hospital needs to arrive at ICU within 20 minutes (details supplied); the way that this patient category differs from a patient in University Hospital Waterford suffering a heart attack given that the Cath laboratory suite is closed and evidenced transfer times to Cork can take upwards of three hours; and if he will make a statement on the matter. [27758/22]

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Written answers

It is Government policy, as reiterated in the National Maternity Strategy, to co-locate stand-alone maternity hospitals with adult acute hospitals. Co-location of maternity services with adult services provides mothers with access to a full range of medical and support services should the need arise, in line with international best practice. In order to be successful in terms of enabling immediate access in an emergency, co-location requires physical adjacencies and specific corridor-linkages from one hospital to the other. The availability of these services helps ensure the delivery of an optimum, safe service, particularly for high-risk mothers and babies.

The National Maternity Hospital (NMH) will be the first of our remaining stand-alone maternity hospitals to be co-located as its current infrastructure is recognised as no longer being fit for purpose. The co-location of the NMH with St Vincent’s University Hospital will make the wide range of general medical, surgical and diagnostic facilities on the Elm Park campus available to any woman who needs to be transferred from the adjacent maternity hospital, resulting in care provision that is far superior to the existing situation.

It should be noted that, women giving birth will sometimes – and thankfully, only in limited numbers – need emergency care and Level 3 ICU and pregnant women will often need multidisciplinary care, for instance if they have co-morbidities.

Annually, several hundred pregnant women require transfer to St Vincent’s University Hospital as inpatients or outpatients for treatment that is not available at Holles Street. Annually, a small number of critically ill women are transferred to receive intensive care not available on site at Holles Street.

The new co-located hospital will provide spacious facilities in a modern campus approach to healthcare, where a range of medical entities operate in close proximity to improve patient care and patient outcomes. The design of the new NMH has been developed to the highest standards to support best possible outcomes. For example, the design locates NMH theatres adjacent to the Level 3 ICU at St Vincent’s University Hospital, specifically to facilitate immediate transfer in the small number of cases where this is needed.

Disabilities Assessments

Questions (723)

Pauline Tully

Question:

723. Deputy Pauline Tully asked the Minister for Health the number of children who received a preliminary team assessment as part of the standard operating procedure that was in place for children’s disability network teams until the Supreme Court ruling in March 2022; the number of these children who were referred for further assessment; the number of these children who have subsequently requested a full assessment of need; the estimated timeframe within which these assessments will be undertaken; and if he will make a statement on the matter. [27759/22]

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Written answers

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

Mental Health Services

Questions (724)

Catherine Murphy

Question:

724. Deputy Catherine Murphy asked the Minister for Health the number of beds that are available nationally in CAMHS; if he will provide a breakdown, by CHO area and by hospital and or residential setting; and the number of the shortfall in beds by CHO area. [27764/22]

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Written answers

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

Ukraine War

Questions (725)

Cathal Crowe

Question:

725. Deputy Cathal Crowe asked the Minister for Health if his Department has considered making the HSE owned 17-bedroom Inis Ghile building in Parteen, County Clare available for Ukrainian refugees, given that it is currently lying idle despite being fully-renovated in recent years. [27765/22]

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Written answers

I would like to thank Deputy Crowe for his question. 

It is vital that we provide the best, holistic response to ensure the safety of, and provide support to, Ukrainian people arriving in Ireland as a result of the conflict in Ukraine.

The Department of Children, Equality, Disability, Integration and Youth is responsible for the provision of emergency refugee accommodation. 

The Department of Housing, Local Government and Heritage is focusing on the medium and long-term accommodation challenges and leading cross-government efforts through a Housing Taskforce established by Government for this purpose.  

This work involves considering a number of options, including refurbishment and reconfiguration of vacant public and private owned buildings as multi-occupancy accommodation for Ukrainian refugees. 

As part of this work, my Department and the HSE have submitted a list of potentially suitable properties to the Department of Housing, Local Government and Heritage, with the aim that those that might be suitable for use as multi-occupancy accommodation can be brought into use for such purposes. 

With specific regard to the property at Inis Ghile, Parteen, Co. Clare, I can confirm that the building has not been identified by the HSE as a potentially suitable property which may potentially be used to provide accommodation for refugee housing, as the HSE have requirements for its use.

The HSE owned property at Inis Ghile in Parteen has been used intermittently for the immunisation programme by the HSE's Community Health public health team during 2021. However going forward it will revert to being used by the Mental Health Service for its East Clare Child and Adolescent Mental Health Services.

Hospital Staff

Questions (726)

Ged Nash

Question:

726. Deputy Ged Nash asked the Minister for Health when stakeholders will receive a letter confirming funding for the Sláintecare: Towards Self-Care in Headache project so that the participating hospitals can retain and recruit vital staff, as per his Department’s announced roll-out (details supplied); and if he will make a statement on the matter. [27766/22]

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Written answers

The Sláintecare Integration Fund project Towards Selfcare in Headache is delivered by the HSE Clinical Strategy & Programme Division. This project involves shifting the balance of care from the acute hospital setting and into the community by offering holistic, patient-centred care, at the lowest level of complexity. The purpose is to reduce the reliance on secondary/tertiary care, harness existing resources within the community network, and to promote a programme of self-care and self-management for those with chronic disorders. The target group for the project are patients with headache disorders.

The project has established new protocols for management of headache, that provide for trained nurse prescribers who work alongside neurologists with expertise in headache, and in collaboration with GPs, the Migraine Association of Ireland and local pharmacies.  85 pharmacists are participating in the programme and over 360 patients have been referred to community pharmacy.

Significant improvements in new/return ratio in the headache clinic in St James Hospital were observed. Following a successful evaluation, ongoing funding is being provided for this project in the participating hospitals. A letter confirming same issued on Friday 27 May 2022.

Industrial Disputes

Questions (727)

Malcolm Noonan

Question:

727. Deputy Malcolm Noonan asked the Minister for Health if his attention has been drawn to the industrial action of medical scientists (details supplied); his views on same; the steps he will take to resolve the issue; and if he will make a statement on the matter. [27774/22]

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Written answers

Firstly, I would like to acknowledge and pay tribute to the dedication, professionalism and commitment of all medical scientists throughout the country. Their drive and dedication have been key components in our managing of the pandemic.

I acknowledge the MLSA’s claim for pay parity between medical scientists and clinical biochemists. As you may be aware, the current public service agreement, Building Momentum 2021-2022, includes the process of Sectoral Bargaining, to address outstanding claims such as this one. Despite continued engagement between the MLSA and Health management since November 2021, and several proposals being explored, it has not been possible to agree a route to fully resolve the longstanding claim due to insufficient funds being available through Sectoral Bargaining.

This matter was escalated through the dispute resolution mechanisms under Building Momentum and considered twice by the Public Service Agreement Group (PSAG) on 31 March and 11 May. PSAG recommended that this matter be referred to the WRC for urgent engagement and that industrial peace be maintained. The MLSA met with Health management on May 17th at the WRC, however, no resolution was reached. 

Following engagement at the Labour Court on May 25th , the parties have agreed to reconvene at the WRC for a further final engagement.  This engagement will take place within a three week period. Any outstanding issues that cannot be resolved through the WRC process will be referred to the Labour Court.  All industrial action will be suspended throughout the engagement process and pending any Labour Court Recommendation.

I welcome the engagement that took place through the Labour Court and the suspension of industrial action. 

Departmental Staff

Questions (728)

Sorca Clarke

Question:

728. Deputy Sorca Clarke asked the Minister for Health the number of workers in his Department and in each office or agency under the aegis of his Department that are not employed directly but are employed by a private company. [27775/22]

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Written answers

There are no workers in my Department that are not employed directly by the Department. 

I have asked the HSE to respond directly to the Deputy in relation to their workforce.  Information for other agencies under the aegis of my Department is being collated and will be provided directly to the Deputy once available.

Vaccination Programme

Questions (729)

Pa Daly

Question:

729. Deputy Pa Daly asked the Minister for Health his views on the accessibility of the Covid-19 booster programme, especially in relation to appointments made through off-line methods. [27804/22]

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Written answers

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

Mental Health Services

Questions (730)

Verona Murphy

Question:

730. Deputy Verona Murphy asked the Minister for Health the current staffing levels within the Wexford CAMHS services; the vacancies that are presently available within the Wexford CAMHS services; the vacancies that are currently with the national recruitment services; and if he will make a statement on the matter. [27805/22]

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Written answers

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

Nursing Homes

Questions (731)

Réada Cronin

Question:

731. Deputy Réada Cronin asked the Minister for Health if unannounced HIQA inspections of nursing homes will be made in the evenings given the concern of families that bed-bound patients have no food or drink from five to six pm until breakfast time the following morning; and if he will make a statement on the matter. [27851/22]

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Written answers

The Chief Inspector within HIQA is legally responsible for the monitoring, inspection and registration of designated centres for older people, such as nursing homes, in Ireland. HIQA carries out different types of inspections; most of which are currently unannounced. The timing of inspections is informed by the information available to inspectors, with most taking place during the day, Monday to Friday. However, if information suggests that there may be issues occurring in a nursing home in the early morning, evening, at night or at the weekend, inspections may be carried out at these times.

If the deputy wishes to give feedback or raise a concern about the care or support in a health or social care service, this can be done by contacting HIQA directly via the contact details on their website. 

Nursing Homes

Questions (732)

Réada Cronin

Question:

732. Deputy Réada Cronin asked the Minister for Health if his Department is satisfied that any cost cutting measures in private nursing homes are not affecting standards of care; the actions that his Department has taken to satisfy itself of same; and if he will make a statement on the matter. [27852/22]

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Written answers

I am aware of the specific challenges faced by the Nursing Home sector related to price inflation and increased energy costs. I have met directly with Nursing Homes Ireland, the representative organisation for private and voluntary nursing homes, to discuss this issue, and have written to the National Treatment Purchase Fund to request that they consider the matter alongside departmental officials.

Funding to support people to access services in the sector continues to be provided in line with the long-established statutory mechanisms under the Nursing Homes Support Scheme Act 2009. This is the mechanism established by the Oireachtas to provide for the processes relating to funding under the NHSS and the negotiation of prices for services for private and voluntary providers with the designated State agency, the National Treatment Purchase Fund (NTPF). The NTPF has statutory independence, and neither I nor the Minister for Health have any role in NHSS price negotiations. 

The Health Act 2007 introduced a significant change to how residential care settings (public and private nursing homes) for older people are inspected and registered.  The Health Information and Quality Authority (HIQA) is the statutory independent regulator for this sector and this responsibility is underpinned by a comprehensive quality framework comprising of Registration Regulations, Care and Welfare Regulations and Quality Standards.   As a regulator HIQA has no legal role in examining individual complaints, however, the Authority does take into account all information it receives, including complaints from the public, when carrying out inspections. 

It is also important to reflect that all nursing homes, as registered providers with HIQA, have well-established obligations under the legal framework in terms of the delivery of safe care to residents. Nursing homes are required, by law, to ensure that procedures consistent with the standards published by HIQA are implemented by staff.

Assisted Human Reproduction

Questions (733)

Denis Naughten

Question:

733. Deputy Denis Naughten asked the Minister for Health when legislation will be published dealing with international surrogacy; and if he will make a statement on the matter. [27879/22]

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Written answers

As the Deputy will be aware, international surrogacy raises complex ethical questions concerning areas of law that intersect across the remits of several Government Departments and require detailed examination. The issues which arise from Irish people engaging in cross-border surrogacy primarily relate to parentage, guardianship, citizenship and, potentially, adoption.

Earlier this year I published and initiated the Health (Assisted Human Reproduction) Bill 2022 (AHR). The focus of this Bill is on the regulation, for the first time in this country, of a wide range of practices undertaken in this jurisdiction exclusively, and particularly those carried out by the private fertility clinics operating here. The published Bill does not contain provisions to regulate surrogacy arrangements undertaken in other jurisdictions, as this was not the intended purpose of the Bill. 

An Oireachtas Joint Committee on International Surrogacy was also established this year to consider and make recommendations on measures to address issues arising from international surrogacy. The work of that Committee is ongoing. 

My colleagues the Ministers for Justice, and for Children, Equality, Disability, Integration and Youth and I will consider the findings and any recommendations made by that Committee in respect of international surrogacy.

Subject to the Committee’s findings and recommendations, it is not clear, at this juncture, whether the AHR Bill will be the appropriate vehicle for accommodating legislative proposals, or whether the amendment of other relevant legislation on the Statute Book is more appropriate. The Deputy will also appreciate that, at this time, it is also not clear if the output of the Committee’s work will focus on legislative recommendations or other types of intervention, if any. This will only become clearer as the Committee’s work progresses.

The Health (Assisted Human Reproduction) Bill 2022 passed Second Stage in the Dáil on March 23rd 2022 and has been referred to the Select Committee on Health for Third Stage. I am particularly determined to progress this much-needed and long-awaited piece of historic legislation as quickly as possible and avoid any further delays to a robust regulatory framework for AHR being put in place. Crucially, this would also adversely impact upon the Government’s plans to introduce the provision of IVF and other advanced AHR treatments through the public health system.

Nevertheless, I am fully committed to supporting the work of the Committee and having regard to its work in the context of the AHR Bill where possible and appropriate, and my officials will continue to work collaboratively with it and other relevant Departments in respect of examining the issues concerned, as it has done to date.

Dental Services

Questions (734)

Brendan Griffin

Question:

734. Deputy Brendan Griffin asked the Minister for Health further to Parliamentary Question No. 618 of 24 May 2022, if he will provide a list of dentists in County Kerry who are providing services for medical card holders under the dental treatment services scheme; the number of dentists who recommenced the scheme since the scheme was expanded and the fees for contractors were increased at the beginning of May 2022; and if he will make a statement on the matter. [27881/22]

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Written answers

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

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