Tuesday, 21 Jun 2022

Proposed Legislation

Questions (751)

John Lahart

Question:

751. Deputy John Lahart asked the Minister for Health when he will be bringing forward legislation to provide for free contraception as pledged in Budget 2022. [32047/22]

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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 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 Working Group’s Report, the Programme for Government, 2020 commits to providing free contraception for women, starting with the 17-25 age cohort.

My Department's Contraception Implementation Group was convened in July, 2021 and has been working with partners, including the HSE, towards ensuring that the scheme will commence in Q3, 2022. Funding of approximately €9m has been allocated for this in Budget 2022.

The scheme will provide for:

- The cost of prescription contraception;

- The cost of necessary consultations with medical professionals to discuss suitable contraception for individual patients and to enable prescription of same;

- 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;

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

- The cost of providing the wide range of contraceptive options currently available to GMS (medical) card holders, which will also be available through this scheme, including contraceptive injections, implants, IUS and IUDs (coils), the contraceptive patch and ring, and various forms of oral contraceptive pill, including emergency contraception.

- The scheme will be open to all 17-25 year-olds ordinarily resident in Ireland.

Formal consultations with medical representative bodies with regard to service provision under the scheme have commenced and are ongoing. Following advice from the Attorney General's office regarding the legal framework for the scheme, consideration is being given to providing this by way of primary legislation.

The design of citizen engagement information and publicity campaigns to support and promote the roll out of the scheme will be finalised in the coming months, to be launched in the month preceding and during the initial phase of scheme roll-out.

Emergency Departments

Questions (752)

Gerald Nash

Question:

752. Deputy Ged Nash asked the Minister for Health the additional resources that will be made available by the HSE to Our Lady of Lourdes Hospital to accommodate the additional resource demands that will be placed on the hospital arising from the plans to discontinue the emergency department service at Our Lady’s Hospital in Navan, County Meath; and if he will make a statement on the matter. [32055/22]

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Written answers

Minister for Health

The Smaller Hospitals Framework was approved by Government and published in 2013. The Framework included a list of nine designated Model 2 Hospitals, including Our Lady’s Hospital Navan. Navan will be the last of those hospitals to transition to Model 2.

The HSE has advised that changes to the services at Navan, in line with the Government Decision, are necessary to support safe service delivery on a sustained basis. In particular, the HSE has been clear that the relatively small number of unstable and critically ill patients who currently present to the Navan ED will have the best chance of survival by being brought directly to a Model 3 or Model 4 hospital with all the necessary specialties.

The HSE advises there has been almost €100m in capital investment in hospitals in the North Eastern region sincec 2016, including almost €62m in Our Lady of Lourdes, allowing for construction, fit out and equipping of a suite of five theatres, ED expansion including reconfiguration of the existing ED and equipping of the surgical ward, construction of a new ward block and a second CT scanner. The HSE also advises that 84 beds to date have opened at Our Lady of Lourdes, with a further 10 planned.

I intend that resourcing plans will be further reviewed within the coming weeks, in order to provide assurance they are sufficiently robust before any changes to services are implemented.

The vision for Navan in the future is that it will be a core element in the delivery of integrated care for patients in line with the Sláintecare vision, with the vast majority of current footfall expected to continue. The proposed changes envisage Navan delivering more care, not less, including medical care, diagnostics, rehabilitative care, elective surgery including orthopaedics and with a 24/7 Medical Assessment Unit and 12/7 Local Injury Unit.

Healthcare Policy

Questions (753)

Cormac Devlin

Question:

753. Deputy Cormac Devlin asked the Minister for Health if he will provide an update on the roll-out of the Womens' Health Taskforce recommendations specifically in relation to menopause; and if he will make a statement on the matter. [32059/22]

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Written answers

Minister for Health

As Minister for Health, I recognise that menopause is a key health issue for women in Ireland today. In 2019, the Women's Health Taskforce was established to improve women's health outcomes and experiences in Ireland.

The Taskforce has listened to, engaged with and worked with more than 2,000 individuals and organisations representing women across the country. Awareness of menopause and its symptoms has been emphasised 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.

On the 8th of March 2022, International Women’s Day, I launched the Women's Health Action Plan 2022-2023. This Action Plan is the first of its kind in Ireland and marks a significant milestone in our efforts to improve women's health. The plan was informed by the work of the Women’s Health Taskforce and commits to grow the available supports, services and expertise available to women before, during and after menopause.

Budget 2022 provided unprecedented funding for measures related to Women's Health. This includes €5.3 million to grow access to “see and treat” gynaecology clinics (to 20 nationally); specialist menopause clinics (to 4 nationally); and specialist endometriosis services (to 2 nationally).

The first of the dedicated specialist menopause clinics opened in the National Maternity Hospital last December 2021.

The Women’s Health Action Plan 2022-23 committed to developing 3 further specialist menopause clinics nationally in Limerick, Cork and Galway. These three clinics will be developed as part of the maternity networks in the South-South West, University of Limerick, and Saolta Hospital Groups.

The Women’s Health Fund (€10 million) was established as part of the Women’s Health Action Plan to fund new initiatives and investments in 2022. The purpose of the Women's Health Fund is to allow the Department to listen to women and be responsive to the issues they raise in-year.

In April 2022, I accelerated the delivery of menopause clinics with a further ring-fenced investment of €2.5 million via the Women’s Health Fund. This funding will support two additional specialist menopause clinics, at the Coombe and the Rotunda, delivering a total of 6 such clinics nationwide, one in each maternity network, for women who require complex, specialist care.

The specialist menopause clinic within the University of Limerick Hospital Group is located in Nenagh General Hospital and the HSE has advised that this clinic opened in May of this year.

The majority of women who seek support for their menopause can be effectively supported within primary care by their GP. Clinical teams within the specialist menopause clinic setting will also provide advice and guidance to GPs in the community to support the effective management of menopausal symptoms for women closer to home within primary care.

The first-of-its-kind ICGP post of Clinical Lead for Women’s Health in General Practice has been established. In March 2022, Dr Ciara McCarthy took up post as the Women's Health Clinical Lead. Her role will enable the development of a comprehensive life-course approach to women’s health in general practice, where the vast majority of advice and services for women at all stages in their health journey is available. Along with the appointment of Dr McCarthy, the ICGP, through HSE funding, developed and successfully delivered a new comprehensive Certificate Course in Community Gynaecology for GPs, which included a menopause-specific module, providing GPs with up-to-date, evidence-based training in the area of gynaecology in general practice. 670 GPs registered to attend at least one module on the course, with 170 attending the full programme.

In 2021, the Women’s Health Fund financed the GP Quick Reference Guide on Menopause. The guide will be disseminated through an article in the ICGP Forum journal. It will also be advertised in the ICGP e-zine to members, through Twitter, the front page of the ICGP website and through a webinar.

The Civil Service Employee Assistance Service is commencing a wider Civil Service engagement network which will support the development of Menopause in the Workplace policies and practices in departments. Officials from the Department of Health, representing our Equality, Diversity and Inclusion Group and our Strategic HR Unit, will participate in this new CSEAS Network. The CSEAS is committed to sharing information with the members of this network, such as best practice, policy information from other jurisdictions and others’ experiences in development of such a policy, to assist Department’s in developing a workplace menopause policy.

The Women’s Health Taskforce and I are committed to changing the approach to menopause care to increase the public supports available to women before, during and after menopause.

Health Services

Questions (754)

Cormac Devlin

Question:

754. Deputy Cormac Devlin asked the Minister for Health if his attention has been drawn to the case of a person (details supplied) who requires a place in the autism initiative centre in Dún Laoghaire given that this is their local and most suitable adult day care service; and if he will make a statement on the matter. [32060/22]

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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, as soon as possible.

Covid-19 Pandemic

Questions (755)

Cormac Devlin

Question:

755. Deputy Cormac Devlin asked the Minister for Health the status of the proposed scheme to compensate families who lost a frontline healthcare worker to Covid-19; when the terms will be finalised; and if he will make a statement on the matter. [32062/22]

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Written answers

Minister for Health

As announced in March I have received Government approval to establish a Covid-19 Death in Service Ex-Gratia scheme. The scheme is being established on an administrative basis to provide an ex-gratia lump sum payment of €100,000 in respect of health and social care workers whose death is attributed to Covid-19 and where they are believed to have contracted it in the workplace.

Pobal are engaged to administer the scheme on behalf of the Department and applications will be accepted from either the Executor/Administrator (legal personal representative) of the deceased or a solicitor acting on their behalf. The guidelines and details regarding making applications are currently being finalised. It is expected to open the scheme to applicants in the Autumn. Officials from my Department are liaising with the healthcare providers to provide information to potential applicants. A website and information line will be provided shortly.

Health Services

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Written answers

Minister for Health

I propose to take Questions Nos. 756, 761, 788, 905 and 919 together.

The expansion of the National Newborn Bloodspot (NBS) Programme is a priority for me, and the National Screening Advisory Committee (NSAC) has been progressing work on this expansion.

The NSAC is an independent, expert committee which makes recommendations to me and my Department on new screening programmes, as well as changes to existing population-based screening programmes, based on international processes and best practice.

The NSAC has been working closely with HIQA, clinicians and other stakeholders, including patient advocates, in setting out the best approach for Ireland in relation to the further expansion of newborn screening.

I am pleased to report recent progress in expanding newborn screening with a ninth condition, ADA-SCID (Adenosine Deaminase Deficiency Severe Combined Immunodeficiency), being added to the NBS programme on 23 May 2022. The NSAC has commissioned HIQA to undertake a Health Technology Assessment (HTA) looking at the addition of other SCID types to the NBS programme. This HTA is underway and I am looking forward to receiving a recommendation from the Committee on this condition after the HTA process is finalised later this year.

The NSAC is now well established and recently published its second annual report which detailed significant progress in 2021. The Committee's first Annual Call for proposals for new screening programmes or changes to our existing programmes, received a significant response with a total of 53 submissions received, including on newborn screening. Submissions were received from various sources and are now undergoing consideration by the committee. The NSAC intends to publish its full work programme later this year once it has considered all proposals submitted.

Given that this is a complex area, careful consideration must be given to the expansion of the NBS programme and these things can take time, however, it is important that decisions are made based on internationally accepted criteria and scientific rigour.

I am aware of how difficult it is for parents whose children have received a diagnosis of a rare disease, and how challenging daily life can be for them, their families and their children. It can be an overwhelming situation and can be very isolating for many families because of the significant work that is involved when a rare disease is diagnosed. I am committed to the further expansion of newborn screening in Ireland and in identifying opportunities for future additions to it.

Wards of Court

Questions (757)

Thomas Pringle

Question:

757. Deputy Thomas Pringle asked the Minister for Health the number of wardship applications that were made by the HSE in March, April, May and to date in June 2022; and if he will make a statement on the matter. [32083/22]

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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.

Departmental Regulations

Questions (758)

John Lahart

Question:

758. Deputy John Lahart asked the Minister for Health the categorisation, if any, concerning nitrous oxide capsules; if they are considered legal or illegal or a danger to health; the steps his Department has taken to deal with them or manage the abuse of them which is widespread; and if he will make a statement on the matter. [32097/22]

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Written answers

Minister of State at the Department of Health

Nitrous oxide falls under the definition of a psychoactive substance and a solvent. Section 3 of the Criminal Justice (Psychoactive Substances Act) 2010 states that a person who sells a psychoactive substance knowing or being reckless as to whether that substance is being acquired or supplied for human consumption shall be guilty of an offence.

Section 74 of the Child Care Act 1991 states that it shall be an offence for a person to sell, offer or make available a substance to a person under the age of eighteen years or to a person acting on behalf of that person if he knows or has reasonable cause to believe that the substance is, or its fumes are, likely to be inhaled by the person under the age of eighteen years for the purpose of causing intoxication.

Responsibility for these Acts lays with the Department of Justice and the Department of Children, Equality, Disability, Integration and Youth, respectively. It is the responsibility of An Garda Síochána to enforce this legislation and to confiscate supplies of this drug.

To support the public health response to the use of nitrous oxide, the Health Service Executive (HSE) has developed a number of resources including information factsheets for concerned parents as well as harm reduction factsheets for people who use nitrous oxide in this manner. These factsheets have been widely circulated and are available to download from the Drugs.ie website, (www.drugs.ie/resources/factsheets/) or by direct request from the HSE.

In response to specific concerns regarding the use of nitrous oxide, drug and alcohol task forces have taken a pro-active approach to communicating with parents and youth workers the dangers associated with its use. A number of webinars were hosted with the aim of up-skilling local professionals regarding the use of nitrous oxide. Speakers at these events included a UK professional, the HSE, and professionals from local areas in which this had been identified as an issue. The Ballymun Drug and Alcohol Task Force Webinar is available online for those who wish to learn more about the topic: www.drugs.ie/features/feature/ballymun_drug_and_alcohol_task_force_webinar

The HSE use social media to educate the public about nitrous oxide, the risks associated with its use and how to reduce the harms. This content is aimed at those over the age of 18 years, as well as parents, to encourage them to provide information and education to those under the age of 18. Messages have been shared as part of this online campaign about the impact of long-term use of nitrous oxide, the associated risks, and how people can reduce the harms to their health.

Under the national drugs strategy, the Dept of Health has established a strategic implementation group to focus and drive Prevention, Education and Awareness to build skills and confidence in young people and encourage healthy choices and behaviour. The Dept will soon announce details of a funding programme to encourage the development of evidence-based prevention measures

I am very supportive of the efforts of An Garda Síochána in confiscating supplies of nitrous oxide. I am committed to continuing to resource harm reduction and prevention and education campaigns aimed at increasing awareness of the risks of drug use, including nitrous oxide.

Health Services

Questions (759)

Seán Sherlock

Question:

759. Deputy Sean Sherlock asked the Minister for Health his views on the closure of a health centre in Castlemartyr, County Cork. [32098/22]

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Written answers

Minister for Health

As the HSE has responsibility for the provision, along with the maintenance and operation of Primary Care Centres and other Primary Care facilities, the Executive has been asked to reply directly to the Deputy.

Hospital Waiting Lists

Questions (760)

Kathleen Funchion

Question:

760. Deputy Kathleen Funchion asked the Minister for Health when a person (details supplied) can expect their cancelled surgery to go ahead; and the guarantees he can give that it will not be cancelled again. [32101/22]

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Written answers

Minister for Health

I fully acknowledge the distress and inconvenience for patients and their families when elective procedures are cancelled, particularly for clinically urgent procedures. While every effort is made to avoid cancellation or postponement of planned procedures, the HSE has advised that planned procedures and operations can be postponed or cancelled for a variety of reasons including capacity issues due to increased scheduled and unscheduled care demand.

Patient safety remains at the centre of all hospital activity and elective care scheduling. To ensure services are provided in a safe, clinically-aligned and prioritised way, hospitals are following HSE clinical guidelines and protocols.

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.

Question No. 761 answered with Question No. 756.

Wards of Court

Questions (762)

Patrick Costello

Question:

762. Deputy Patrick Costello asked the Minister for Health the number of wardship applications that were made by the HSE in March, April, May and to date in June 2022; and if he will make a statement on the matter. [32105/22]

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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.

Hospital Waiting Lists

Medicinal Products

Questions (768)

Catherine Murphy

Question:

768. Deputy Catherine Murphy asked the Minister for Health if he will approve the funding of osempic under the long-term illness scheme or drug payment scheme for illnesses other than diabetes; and if he will make a statement on the matter. [32154/22]

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Written answers

Minister for Health

The Health Service Executive (HSE) has statutory responsibility for medicine pricing and reimbursement decisions, in accordance with the Health (Pricing and Supply of Medical Goods) Act 2013.

In line with the 2013 Health Act and the national framework agreed with industry, a company must submit an application to the HSE to have a new medicine added to the reimbursement list. Reimbursement is for licenced indications which have been granted market authorisation by the European Medicines Agency or the Health Products Regulatory Authority.

In making a relevant reimbursement decision, the HSE is required under the Act to have regard to a number of criteria including efficacy, the health needs of the public, cost effectiveness and potential or actual budget impact. HSE decisions on which medicines are reimbursed by the taxpayer are made on objective, scientific and economic grounds, on the advice of the National Centre for Pharmacoeconomics (NCPE). The Minister for Health has no role in these decisions.

Ozempic® (semaglutide) is licensed with the Health Products Regulatory Authority (HPRA) in Ireland, and is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. Ozempic® (semaglutide) was approved by the HSE for addition to the Reimbursement List for the treatment of Diabetes in 2018. Semaglutide has not been approved for reimbursement for any other indication to date.

Controls are in place within the HSE Primary Care Reimbursement Service scheme management systems on claiming processes to ensure that only HSE approved indications are reimbursed across a range of medicines. Controls are currently in place in relation to Ozempic® (semaglutide) to restrict reimbursement support to the HSE approved indication of Diabetes. Persons with Diabetes are eligible for the Long Term Illness scheme and may access Semaglutide via that eligibility. Therefore, it is not made available on the Drug Payment Scheme.

Hospital Facilities

Questions (769)

Mark Ward

Question:

769. Deputy Mark Ward asked the Minister for Health the progress on the refurbishment in Mount Carmel including any additional costs; and if he will make a statement on the matter. [32158/22]

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Written answers

Minister for Health

As 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.

Health Services Staff

Questions (770)

Mark Ward

Question:

770. Deputy Mark Ward asked the Minister for Health the recruitment plans the HSE have to fill vacant mental health nursing posts; and if he will make a statement on the matter. [32159/22]

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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 directly to the Deputy as soon as possible.