Written Answers Nos. 97-111
97. Deputy Cathal Berry asked the Minister for Health the number of members of the Defence Forces who are entitled to claim the pandemic bonus payment; the number of members of the Defence Forces who have been paid to date; and if he will make a statement on the matter. [33759/22]
View answerI would like to extend my sincere gratitude to all healthcare workers for their efforts during this most challenging period.
On January 19th, the Government announced a COVID-19 pandemic recognition payment for certain front-line workers in healthcare settings, to recognise their unique role during the pandemic.
Following extensive engagement with healthcare unions on the matter, criteria for eligibility of payment for HSE and Section-38 staff was published on 19th April. Officials are now working to progress payments to those members of the Defence Forces redeployed to front-line covid-exposed clinical settings in the HSE.
This is a complex task because:
- these employees are not normally paid by the public health service,
- duplicate payments need to be avoided, and
- there are many other organisations to be covered alongside the Defence Forces as the payment is rolled out.
With that in mind, figures are not yet available for the number of staff eligible. I understand that officials in the Department of Defence and the Defence Forces are engaging on this matter and further information will be available regarding eligible cohorts in the coming weeks.
98. Deputy Willie O'Dea asked the Minister for Health the improvements in dementia care that have been put in place over the past two years; the further developments that are planned; and if he will make a statement on the matter. [37465/22]
View answerI have long been an advocate for the development of services for people with dementia and their families and this is representative in the focused investment in these supports and services in recent years. A key commitment of this Government is to continue implementing the National Dementia Strategy so that people living with dementia can live well for as long as possible.
In 2022 there was €15million of increased investment dedicated to dementia specific supports and services, on top of the €12.9million additional funding from 2021. This unprecedented level of increased funding for dementia specific services has allowed for substantial advancements across a number of areas including:
- Dementia diagnostic services with two new regional specialist memory clinics and 9 new memory assessment and support services
- Enhancement of acute care pathways for people with dementia through the recruitment of dementia specific posts and the implementation of a clinical guideline
- Post diagnostic supports through the enhancement of memory technology resource rooms across the country
- Increase the proportion of home support hours ringfenced for people with dementia to 11%
In addition, funding in 2021 allowed for an expansion of the Dementia Advisor Network from 8 to 29 advisors providing support to people with dementia across the country.
A Model Care for Dementia has been developed by the HSE. This outlines care pathways for people with dementia from early signs/symptoms through to assessment, diagnosis, disclosure, care planning and post-diagnostic support.
99. Deputy Jim O'Callaghan asked the Minister for Health the number of people with disabilities that have benefitted from the changes to the medical card assessment process that took effect in December 2018; and if he will make a statement on the matter. [37556/22]
View answerEligibility for a medical card is primarily based on a financial assessment which is conducted by the HSE in accordance with the Health Act 1970.
Since December 2018, the medical card earnings disregard for people in receipt of Disability Allowance was increased from €120 to €427 per week. It applies to the assessment process for both single people and to family assessments. This measure gave effect to an important recommendation of the Make Work Pay for People with Disabilities report. It enables people in receipt of the disability allowance to have a higher level of earnings and still retain their medical card.
The HSE does not routinely collate information to facilitate a detailed breakdown in the manner sought. The HSE has, however, provided a high-level analysis which indicates that 3,000 persons approximately are estimated to have benefited from the measure. The substantial increase in allowable earnings introduced in 2018 acknowledges that a Medical Card is a particularly significant support and ensures that people with disabilities can continue to be supported to access care when needed.
Furthermore, people who have been on a disability payment for at least a year can retain a Medical Card for a further three years on return to work, provided they were in receipt of the payment for a period of at least 12 months prior to commencing employment.
100. Deputy Catherine Connolly asked the Minister for Health further to Parliamentary Question No. 43 of 26 May 2022, if the Strategic Assessment Report by the HSE regarding the new emergency department in University Hospital Galway has been submitted to his Department to date, as per the expected timeline of early Q3 2022; and if he will make a statement on the matter. [37624/22]
View answerI am pleased to confirm that the Strategic Assessment Report (SAR) for the proposed Emergency Department (ED), Women & Children’s block at University Hospital Galway has recently been submitted to my Department.
The SAR is currently being reviewed to ensure that the proposals align with strategic policy considerations for the services proposed.
I’d like to acknowledge the difficult conditions for patients, families and healthcare staff working in University Hospital Galway.
I visited Galway a few months ago. It is clear that action is required there on multiple fronts- the ED, beds, diagnostics and staffing.
I am pleased to say that the interim ED is nearing completion. This includes additional resuscitation spaces, support accommodation, and improved infection prevention and control measures.
It is expected that new facilities would be available for patients and staff over the summer.
While improving service delivery capability, the interim ED will also serve as enabling works for the larger project; freeing up the site required for the proposed new block.
I am aware that this project has been discussed for over 10 years and I spoke with the team there about this. I subsequently asked for the development of the SAR to be prioritised by the HSE.
One of the reasons that the project is still in development phase is that there has been a very significant increase in the scale and ambition for the solution there.
Proposals are now costed in the hundreds of millions. As the Deputy will be aware, all projects proposed in excess of €100m must be subject to the full scrutiny of the Public Spending Code process.
If the SAR is passed, a preliminary business case will be updated by HSE and be brought forward for further review.
101. Deputy Donnchadh Ó Laoghaire asked the Minister for Health if he will intervene to ensure that the report of the review team into the disposal of perinatal organs at Cork University Maternity Hospital will be furnished to the families affected as soon as possible and with no further delays; and if he will make a statement on the matter. [37486/22]
View answerThe final draft of the report will be furnished to the families affected as soon as possible once the process is complete.
I wish to again express my sympathy to the bereaved families and acknowledge the distress and upset that has been caused to these families. I am aware of the paramount importance of dignity and respect for these parents who have experienced the loss of a child.
Within the public health service, when an incident occurs, it is important that the health service where the incident occurred is responsible for ensuring that the incident is appropriately investigated, so that the service can learn from what went wrong to improve services in the future.
The HSE advise that a Systems Analysis Review of the incident is ongoing. The Review Team continues to have ongoing engagement with the families affected every three weeks with an update provided last week. I understand that the further delay in completion of this review is very upsetting for the families affected.
This incident was originally advised to my Department via the Patient Safety Communications Protocol on 12th May 2020. Officials from my Department have been liaising directly with the HSE on this matter since this time. Following requests from my Department, 19 updates have been received from the HSE with the most recent update provided on 7th July 2022.
I have been provided with formal briefing by my officials on five occasions. They continue to engage directly with the HSE and to brief me on developments.
The HSE advise that the Review Team are currently engaging legal opinion on the draft report before sending to participants in accordance with factual accuracy checking and fair procedures. Once this process is complete the final draft will be shared with the families for input on factual accuracy checking.
102. Deputy David Cullinane asked the Minister for Health if he will invest in additional home care, outreach care and mental health supports for persons with epidermolysis bullosa; and if he will make a statement on the matter. [37356/22]
View answerEpidermolysis bullosa is a rare, life-long genetic condition which causes fragile, blistering skin.
There is no doubt that Epidermolysis Bullosa places a substantial medical, social, and financial burden on patients and carers.
I fully appreciate the difficulties experienced by patients suffering from this painful condition.
There are approximately 300 patients in Ireland with Epidermolysis Bullosa, with approximately 60 new patients presenting with a diagnosis annually.
At present we have a two-centre approach to treating patients; there are approximately 158 patients currently registered between Children’s Health Ireland and St. James’s Hospital.
Children’s Health Ireland currently have one permanent Clinical Nurse Specialist who provides home care and outreach care. This Clinical nurse specialist is community-based and engages with all registered Epidermolysis Bullosa patients on a regular basis.
The service offered by the nurse specialist is pivotal to ensuring that hospital and community-based services are appropriately aligned.
An important example of this work includes securing home nursing care packages ranging from 9 hours to 20 hours for patients.
This service provides expert guidance for families, alleviates anxieties and offers referrals to psychological support in Children’s Health Ireland and the DEBRA Ireland family support service.
In addition, I am pleased to advise that Children’s Health Ireland are also in the final stages of recruiting an Advanced Nurse Practitioner role in Dermatology.
This appointment is another positive development in terms of services for children.
103. Deputy Darren O'Rourke asked the Minister for Health if he will provide an update on his engagement with the HSE in relation the future of the emergency department in Our Lady’s Hospital, Navan; if he will commit to bringing forward proposals to protect and enhance emergency and critical services at the hospital; and if he will make a statement on the matter. [37458/22]
View answerAs the Deputy will be aware, the HSE has proposed a process of planned service changes at Navan. The HSE advises that these changes are necessary to support safe service delivery on a sustained basis and are driven first and foremost by patient safety and very real clinical concerns.
While recognising the very real clinical concerns identified, the Government is clear that several important issues, including additional capacity in other hospitals impacted and the continued ability of people in the Navan area to access emergency and urgent care, would need to be fully addressed before any proposed transition by the HSE.
I have asked the HSE to undertake a process to review, validate and stress test the reconfiguration planning. My Department is currently engaging with the HSE in relation to this process, with a view to it being completed within a matter of weeks.
This process will need to be completed before I consider a definitive date for the implementation of proposed changes. Ongoing preparations for reconfiguration, including consultation can take place in parallel with this process.
104. Deputy Neasa Hourigan asked the Minister for Health if he will outline the basis for the operational requirement that a personal public service number is the only acceptable proof of residence for accessing abortion services without charge; and if he will make a statement on the matter. [37249/22]
View answerIt is my priority to ensure that the Health (Regulation of Termination of Pregnancy) Act 2018 is fully implemented, and is performing as it should be, to enable all women in Ireland to access termination of pregnancy services quickly and easily, without bias or judgment.
Termination of pregnancy services are free of charge to anyone who is ordinarily resident in the State. In the case of a vulnerable person including an asylum seeker looking to access the service, it is my understanding that in any situation where a person requires a Personal Public Service Number (PPSN) to access urgent or emergency medical services, but hasn’t yet been assigned one, the Department of Social Protection can and will allocate a PPSN for that purpose.
There is regular ongoing engagement between the Department of Health and the HSE to facilitate the operation of the service and to resolve any issues that may arise and we will continue to ensure the positive rollout and enhancement of these healthcare services.
The Review of the Health (Regulation of Termination of Pregnancy) Act 2018 which is currently underway will assess the effectiveness of the operation of the legislation. This purpose of the review is to facilitate monitoring of the operation of the legislation in practice, as well as of the delivery of services in the area.
105. Deputy James Lawless asked the Minister for Health the number of home care support hours being provided in each LHO area in CHO7 in 2022; the way that this compares for each of the LHO areas in 2019; the number of persons currently awaiting home care in each LHO area; and if he will make a statement on the matter. [37467/22]
View answerThe overall Budget for Home Support is over 670 million euro. This includes the 150 million I secured in Budget 2021.
In 2022, our aim is to provide 23.67 million hours of home support. This represents about 5.8 million more hours than the 2019 service plan target. This is an increase of over 30%.
The target for CHO 7 is to provide about 2.9 million hours, about 730,000 hours above 2019’s target.
At the end of May preliminary data shows that 55,392 people were receiving home support. Over 8.7 million hours has been delivered year to date.
In CHO 7, 6,253 people were receiving home support and 912,000 hours had been provided. There were 600 people waiting for the service, compared to 1,622 in December 2019.
The number of home support hours in communities is increasing, in line with enhanced investment. Delivering this enhanced capacity requires substantial recruitment. This has been affected due to the strategic workforce challenges in the sector.
I have established an Advisory Group to identify the specific obstacles to recruiting carers. The Group is committed to providing me with a set of recommendations by September.
The HSE continues to advertise for Health Care Assistants. In my ongoing engagements with the Chief Officers, I have recommended that they consider a renewed focus in advertising these positions locally.
106. Deputy Pearse Doherty asked the Minister for Health if he will attend a meeting with an organisation (details supplied), the Manager of Letterkenny University Hospital and the CEO of the Saolta University Health Care Group to hear their concerns regarding the lack of diabetes care services at the hospital and the pressing need for additional services to be provided. [37590/22]
View answer121. Deputy Pádraig Mac Lochlainn asked the Minister for Health if he will meet with the Donegal branch committee of an organisation (details supplied) when he visits the county along with the CEO of a healthcare group and the manager of Letterkenny University Hospital to listen to their serious concerns about diabetes care services at the Hospital and the urgent need for additional resources to be provided. [37216/22]
View answerI propose to take Questions Nos. 106 and 121 together.
Diabetes is a complex condition that can have a profound impact on the quality of life of people living with the condition. If not well managed, it can lead to debilitating complications. Management of the condition is required across the entire spectrum of healthcare delivery including self-management support as well as care delivered through general practice, community specialist care and hospital inpatient specialist care.
I am aware of the challenges faced in provision of hospital diabetes care, including difficulties in filling permanent diabetes care positions. I am open to meeting the organisation concerned, however, due to the busy nature of Oireachtas and Government business, it is not always possible to accept every request.
107. Deputy Gino Kenny asked the Minister for Health if his attention has been drawn to the fact that an organisation (details supplied) is consulting its members on taking industrial action on overcrowding in the country’s emergency departments; and if he will make a statement on the matter. [37646/22]
View answerI wish to express my gratitude for the extraordinary efforts of our front-line healthcare workers, particularly during this period of increased demand on our Emergency Departments.
I have requested that the HSE set out short-term immediate actions to alleviate the pressure on EDs and ensure that our hospitals are ready for winter. I also requested the development of a longer-term plan for reform and improvement of unscheduled care, in line with expected increases in demand driven by population growth and an aging population. This plan will build on the substantial investment over the past two years in initiatives such as additional capacity, more staff, increased home care packages and greater GP access to diagnostics.
Every effort has been made, and continues to be made, to improve the capacity of our health and social care services in response to healthcare needs. Between December 2019 and May 2022, an additional 14,893 Whole Time Equivalent staff have been added to our public health service, 2,387 since December 2021 alone.
Within the Acute Services specifically, there has been an increase of 9,032 WTE since December 2019. This substantial growth comes from the large investment into safely staffing the health service. Of this growth, 3,327 WTE are in the Nursing and Midwifery category, equating to a 14% increase in nursing in the Acute Services since the end of 2019.
My Department and the HSE attend regular industrial relations forums and engagements with the health service representative bodies, and are committed to dealing with disputes arising, through talks and established processes in place.
108. Deputy David Cullinane asked the Minister for Health the status of the Cardiac Services Review; and if he will make a statement on the matter. [37354/22]
View answerThe 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 aim of the Cardiac Services Review is 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 the need for an optimal configuration of a national adult cardiac service. This aligns with the Sláintecare reform programme. In terms of scope, the National Review covers scheduled and unscheduled hospital-based services for the diagnosis and treatment of cardiac disease in adults.
The COVID-19 Pandemic impacted on the progress of the review during 2020 and into 2021 as the Chair of the Cardiac Services Review has played a key role in the national COVID-19 response.
Currently the Steering Group is working on the development of the proposed recommendations of the draft report. Consideration of the implementation process is also part of finalizing the Report and this work is also underway. The Steering Group most recently met on the 26th of May 2022 to further progress the review and the next meeting is currently being planned.
109. Deputy Steven Matthews asked the Minister for Health the position in relation to the Departmental review of the dental medical card scheme; his plans to alleviate access issues to dentists for medical card holders in the short-term; and if he will make a statement on the matter. [37698/22]
View answerThe Dental Treatment Services Scheme (DTSS) provides dental care free of charge to medical card holders aged 16 and over. I have invested an additional €26 million in the Scheme this year over and above what was spent in 2021, €40 million.
This package includes an additional €10 million in Budget 2022 to expand dental health care for medical card holders and reintroduce the Scale and Polish. I am also using an estimated €16 million of an underspend in this year’s estimates allocation (€56 million) to award fee increases across several items.
Following consultation with the Irish Dental Association, these new measures came into effect on 1st May.
These measures are designed to address immediate concerns with the Scheme, pending a more substantive reform of dental services to align with the National Oral Health Policy. The HSE will assist anyone still experiencing problems accessing a service under the Scheme.
I understand that contractors are looking for more substantive reform of the Scheme. It is my intention that this is addressed in the context of the implementation of the National Oral Health Policy, which sets out a body of substantial services reform.
Work is underway to design a governance framework to oversee and facilitate root and branch service reform. The Chief Dental Officer in my Department is already engaging with stakeholders on such reform and I understand that she will shortly be meeting with the Irish Dental Association.
110. Deputy Jennifer Murnane O'Connor asked the Minister for Health when Tullow, County Carlow will get a primary care centre; and if he will make a statement on the matter. [37462/22]
View answerPrimary Care Centres are modern, purpose designed buildings providing a single point of access to health services in the community.
Tullow Co. Carlow has been identified as one of the areas for the development of a new Primary Care Centre (PCC) which will also serve the local communities in Hacketstown and Rathvilly.
It is planned that the new PCC will provide a broad range of services including General Practitioner services, Public Health Nursing, Physiotherapy, Dental, Speech and Language Therapy, Occupational Therapy, and Dietetics. There will also be capacity for visiting clinicians to hold sessional services i.e., Psychology, Podiatry, Counselling, Area Medical Officer, Chronic Disease, etc.
In relation to this planned Primary Care Centre, following an expression of interest, the HSE Estates Division has identified a number of interested developers. A meeting to review and assess the submissions was held in September 2021. The developers indicated their ability to provide the accommodation required by HSE and adequate car parking facilities. A preferred developer has been identified.
The preferred location is within the town boundaries of Tullow. HSE Estates Personnel are working to progress the appointment of the preferred developer. Some final items are yet to be clarified regarding the process. Following this, the next step is for the HSE Board to approve the appointment of the developer. A letter of Intent will then issue as a matter of priority. Thereafter it will be up to selected Developer/provider to finalise site purchase, building design, planning permission and satisfy a number of legal /contractual requirements, before Agreement for Lease/Contract is issued by HSE. On completion of the building construction, HSE will enter a 25-year Lease with the Developer.
It is expected that the developer could be ready to begin construction by Q4 2022 with building complete by end 2023 or early 2024.
111. Deputy Sorca Clarke asked the Minister for Health the engagement that he has had with the Taoiseach and the Minister for Finance in relation to his proposal to bring forward a Bill to provide life-long health and social supports to the survivors of thalidomide. [37667/22]
View answerThe Government is committed to continue to provide survivors of thalidomide with the necessary health supports to meet their related needs.
In addition to an initial ex-gratia lump-sum and monthly payments for life, the supports provided by the Irish State to each Irish survivor include a medical card on an administrative basis regardless of means, which includes access to a full range of primary care, hospital and personal social services, provision of appliances, artificial limbs, equipment and housing adaptations. There is a designated senior manager in the Health Service Executive who liaises with Irish thalidomide survivors and assists them to access supports towards their ongoing health and personal social service needs.
Work is underway in the Department to provide these health and personal social supports on a statutory footing as committed to by the Government.
